Healthcare Provider Details

I. General information

NPI: 1134129125
Provider Name (Legal Business Name): STEPHEN EVAN KABEL D. O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2005
Last Update Date: 07/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 HAINES MILL RD
DELRAN NJ
08075-1715
US

IV. Provider business mailing address

26 HAINES MILL RD
DELRAN NJ
08075-1715
US

V. Phone/Fax

Practice location:
  • Phone: 856-461-6200
  • Fax: 856-461-4013
Mailing address:
  • Phone: 856-461-6200
  • Fax: 856-461-4013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB053566
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0102049854
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB055637
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0102049854
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: