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General NPI Number Information
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NPI Number | 1992722441
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Entity Type | Individual
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Provider Name | STEPHEN JAMES STAUB M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | NMRTC EARLE 201 RTE 34S BLDG C-3
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City | COLTS NECK
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State | NJ
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Zip | 07722
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Country | US
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Telephone | 808-473-1880
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Fax |
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Provider Business Mailing Address
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Address Line | 30 IMLAY LN
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City | FARMINGDALE
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State | NJ
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Zip | 07727-1051
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101238613
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0101238613
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License Number State | VA
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