Healthcare Provider Details

I. General information

NPI: 1437684206
Provider Name (Legal Business Name): STUART CHANGOOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2017
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 HAMBURG TPKE STE 202
WAYNE NJ
07470-2166
US

IV. Provider business mailing address

1317 EAGLES NEST CT
STEWARTSVILLE NJ
08886-2925
US

V. Phone/Fax

Practice location:
  • Phone: 973-870-0777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA202260
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberA202260
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: