Provider Demographics
NPI:1689680209
Name:DREY, IRIS A (MD)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:A
Last Name:DREY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 GALWAY PL
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3606
Mailing Address - Country:US
Mailing Address - Phone:201-833-9500
Mailing Address - Fax:201-862-0095
Practice Address - Street 1:663 PALISADE AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-3012
Practice Address - Country:US
Practice Address - Phone:201-943-9100
Practice Address - Fax:201-943-7308
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06290000207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG53102Medicare UPIN