1063551570 NPI number — MR. DONALD RAYMOND STANTON M.S.W., L.C.S.W.,

Table of content: MR. DONALD RAYMOND STANTON M.S.W., L.C.S.W., (NPI 1063551570)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063551570 NPI number — MR. DONALD RAYMOND STANTON M.S.W., L.C.S.W.,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STANTON
Provider First Name:
DONALD
Provider Middle Name:
RAYMOND
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.S.W., L.C.S.W.,
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STANTON
Provider Other First Name:
DON
Provider Other Middle Name:
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.W., L.C.S.W.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1063551570
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 AVENUE OF THE CMN
Provider Second Line Business Mailing Address:
SUITE 203
Provider Business Mailing Address City Name:
SHREWSBURY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07702-4800
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-747-1413
Provider Business Mailing Address Fax Number:
732-935-1727

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 AVENUE AT THE CMN
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
SHREWSBURY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07702-4532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-747-1413
Provider Business Practice Location Address Fax Number:
732-935-1727
Provider Enumeration Date:
02/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  44SC01299900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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