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General NPI Number Information
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NPI Number | 1821268830
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Entity Type | Organization
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Legal Business Name | STANLEY GOTTLIEB MD
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 07/06/2011
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Provider Practice Location Address
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Address Line | 575 CRANBURY RD B3A
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-5404
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Country | US
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Telephone | 732-238-0035
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Fax | 732-238-0199
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Provider Business Mailing Address
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Address Line | 575 CRANBURY RD B3A
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-5404
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Country | US
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Telephone | 732-238-0035
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Fax | 732-238-0199
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Authorized Official
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Title or Position | SOLO PRACTITIONER
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Name | DR. STANLEY GOTTLIEB
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Credential | M.D.
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Telephone | 732-238-0035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA02907200
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License Number State | NJ
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