1134129125 NPI number — DR. STEPHEN EVAN KABEL D. O.

Table of content: DR. STEPHEN EVAN KABEL D. O. (NPI 1134129125)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134129125 NPI number — DR. STEPHEN EVAN KABEL D. O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KABEL
Provider First Name:
STEPHEN
Provider Middle Name:
EVAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D. O.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134129125
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/28/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26 HAINES MILL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DELRAN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08075-1715
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-461-6200
Provider Business Mailing Address Fax Number:
856-461-4013

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26 HAINES MILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DELRAN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08075-1715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-461-6200
Provider Business Practice Location Address Fax Number:
856-461-4013
Provider Enumeration Date:
07/30/2005

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: 207Q00000X , with the licence number:  25MB053566 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 0102049854 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 25MB055637 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: 0102049854 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1834918 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1K7341 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P2191369 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 24283 . This is a "UNIVERSITY HEALTH PLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0812422001 . This is a "AMERIHEALTH HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2255682 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4122929 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 110230350 . This is a "RAIL ROAD MEDICARE NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1937276 . This is a "FIRST HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 9001905 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2595958 . This is a "GHI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 908306 . This is a "AMERIHEALTH PPO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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