Jay Mickenberg, DPM

NPI 1336149962 · on the registry since 2005 · sole proprietor

Practice

Address: 8094 Edwin Raynor Blvd
Suite C
Pasadena, MD 21122
Phone: (410) 255-0040
Fax: (410) 360-4955
Organisation at this address: Georgina R. Mijares Mdpa
Mickenbergs Ambulatory Foot Care Pa
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: 213E00000X
213E00000X
Licence states on file: MD
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2024-02-21

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Maryland