Healthcare Provider Details

I. General information

NPI: 1811078884
Provider Name (Legal Business Name): WENDY K. STINSON DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

286 UNION AVE LOWER LEVEL
BELLEVILLE NJ
07109-2053
US

IV. Provider business mailing address

286 UNION AVE LOWER LEVEL
BELLEVILLE NJ
07109-2053
US

V. Phone/Fax

Practice location:
  • Phone: 973-751-8637
  • Fax: 973-751-3444
Mailing address:
  • Phone: 973-751-8637
  • Fax: 973-751-3444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00273900
License Number StateNJ

VIII. Authorized Official

Name: WENDY K. STINSON
Title or Position: OWNER
Credential: DPM
Phone: 973-751-8637