1609822840 NPI number — DR. STEPHEN THOMAS MOFFITT M.D.

Table of content: DR. STEPHEN THOMAS MOFFITT M.D. (NPI 1609822840)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609822840 NPI number — DR. STEPHEN THOMAS MOFFITT M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOFFITT
Provider First Name:
STEPHEN
Provider Middle Name:
THOMAS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1609822840
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/31/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 CAPITAL WAY
Provider Second Line Business Mailing Address:
CAPITAL HEALTH SYSTEM @ HOPEWELL, PEDIATRIX MED GROUP
Provider Business Mailing Address City Name:
PENNINGTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08534-2520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-537-6151
Provider Business Mailing Address Fax Number:
609-537-6975

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 CAPITAL WAY
Provider Second Line Business Practice Location Address:
CAPITAL HEALTH SYSTEM @ HOPEWELL, PEDIATRIX MED GROUP
Provider Business Practice Location Address City Name:
PENNINGTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08534-2520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-537-6151
Provider Business Practice Location Address Fax Number:
609-537-6975
Provider Enumeration Date:
05/26/2006

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: 2080N0001X , with the licence number:  25MA06008600 , 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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