Michal Dubowski, MD
Individual provider Active NPI General Practice Physician · Pine Brook, NJ
NPI 1104428499 · NPPES record last updated Jan 31, 2025
Key facts
- NPI
- 1104428499
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- P129347 (NY)
- Practice address
- 25 Riverside Dr Ste 2
Pine Brook, NJ 07058-9391 - Phone
- (224) 628-4001
- NPI assigned
- Nov 11, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08787533 | CA | MD | Family Medicine Physician |
| P129347 | NY | MD | General Practice Physician |
| 18-172 | WI | MD | Surgical Assistant |
| 2019028021 | MO | MD | Physician Assistant |
| NJDCATEMP-001670 | NJ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Terence Cardinal Cooke Health Care Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 08787533 | CA | |
| Surgical Assistant |
246ZC0007X | 18-172 | WI | |
| Physician Assistant | 363A00000X | NJDCATEMP-001670 | NJ | |
| Physician Assistant | 363A00000X | 2019028021 | MO | |
| General Practice Physician | 208D00000X | P129347 | NY | Yes |
Addresses
Primary practice location
25 Riverside Dr Ste 2
Pine Brook, NJ 07058-9391
Mailing address
18 Wyndham PL
Robbinsville, NJ 08691-3121
Phone (224) 628-4001
Other providers in Pine Brook, NJ
- Gabrielle Darienzo
- Denise Ann Deluca
- Jacqueline Anne Doddy
- Stephanie Dorime
- Dr Mack Functional & Family Medicine PC
- Paige Elizabeth Dwight Dickman
- Mitchell L Elias
- Ursula Zienkiewicz Emas
- Empathic Journeys Counseling LLC
- Karol Espejo
All providers in Pine Brook, NJ · General Practice Physician in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.