Healthcare Provider Details

I. General information

NPI: 1396953782
Provider Name (Legal Business Name): STELLAR MEDICAL SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 UNION AVE SUITE 101
RUTHERFORD NJ
07070-1274
US

IV. Provider business mailing address

PO BOX 156
FRANKLIN LAKES NJ
07417-0156
US

V. Phone/Fax

Practice location:
  • Phone: 201-933-4775
  • Fax: 201-935-0549
Mailing address:
  • Phone: 201-969-9996
  • Fax: 201-969-9991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA04443100
License Number StateNJ

VIII. Authorized Official

Name: DR. STEFANO M STELLA
Title or Position: MD/OWNER
Credential: MD
Phone: 201-969-9996