Provider Demographics
NPI:1255434247
Name:DUBOV, IGAL (DC)
Entity type:Individual
Prefix:DR
First Name:IGAL
Middle Name:
Last Name:DUBOV
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1985 STATE ROUTE 34
Mailing Address - Street 2:BLDG A UNIT A5
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-9100
Mailing Address - Country:US
Mailing Address - Phone:732-974-0044
Mailing Address - Fax:732-974-7044
Practice Address - Street 1:1985 STATE ROUTE 34
Practice Address - Street 2:BLDG A UNIT A5
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-9100
Practice Address - Country:US
Practice Address - Phone:732-974-0044
Practice Address - Fax:732-974-7044
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2025-12-04
Deactivation Date:2017-08-01
Deactivation Code:
Reactivation Date:2025-12-04
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00570400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU82278Medicare UPIN
NJ043089Medicare PIN
NJ043089YE6MMedicare PIN
NJ043089YH14Medicare PIN