MEDICARE: STEPHANIE POPPER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	44SL07373200	NJ

General Provider Information

NPI Number	:	1558209304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE POPPER

Provider Business Mailing Address
First Line	:	1923 BAILEYS CORNER RD
Second Line	:
City	:	WALL TOWNSHIP
State	:	NJ
Zip	:	07719-9534
Country	:	US
Telephone Number	:	732-261-9713
Fax Number	:

Provider Business Practice Location Address
First Line	:	1923 BAILEYS CORNER RD
Second Line	:
City	:	WALL TOWNSHIP
State	:	NJ
Zip	:	07719-9534
Country	:	US
Telephone Number	:	732-261-9713
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ STEPHANIE POPPER ” Practice Location

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