Provider Demographics
NPI:1790778405
Name:DOBRO, JEFFREY STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:STEVEN
Last Name:DOBRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SOUTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-9428
Mailing Address - Country:US
Mailing Address - Phone:973-263-0372
Mailing Address - Fax:
Practice Address - Street 1:28 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:POMPTON PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07444-1453
Practice Address - Country:US
Practice Address - Phone:973-835-2575
Practice Address - Fax:973-835-0531
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04148300207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC61337Medicare UPIN
NJ087429MDJMedicare PIN