Provider Demographics
NPI:1174153571
Name:PAUL, STEFAN L (DPT)
Entity type:Individual
Prefix:
First Name:STEFAN
Middle Name:L
Last Name:PAUL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:701 NEWARK AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-3560
Mailing Address - Country:US
Mailing Address - Phone:908-527-6001
Mailing Address - Fax:908-527-6634
Practice Address - Street 1:75 MONTGOMERY ST FL 501
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3726
Practice Address - Country:US
Practice Address - Phone:201-433-6001
Practice Address - Fax:201-433-6634
Is Sole Proprietor?:No
Enumeration Date:2020-01-24
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ40QA01793000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist