Provider Demographics
NPI:1588662845
Name:DAUBER, STANLEY EDWARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:EDWARD
Last Name:DAUBER
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:184 E 70TH ST
Mailing Address - Street 2:SUITE B1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5154
Mailing Address - Country:US
Mailing Address - Phone:212-879-6116
Mailing Address - Fax:212-861-3749
Practice Address - Street 1:184 E 70TH ST
Practice Address - Street 2:SUITE B1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5154
Practice Address - Country:US
Practice Address - Phone:212-879-6116
Practice Address - Fax:212-861-3749
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN002741213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400040905Medicare PIN
T50864Medicare UPIN