Provider Demographics
NPI:1114902467
Name:SERBAN, STELIAN I (MD)
Entity type:Individual
Prefix:DR
First Name:STELIAN
Middle Name:I
Last Name:SERBAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12023
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-5023
Mailing Address - Country:US
Mailing Address - Phone:212-427-2666
Mailing Address - Fax:212-289-6929
Practice Address - Street 1:19 DAVIS AVE # 4
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4488
Practice Address - Country:US
Practice Address - Phone:732-897-3870
Practice Address - Fax:732-974-0366
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002399207LP2900X
NJ25MA11989400207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02662453Medicaid
NYI36566Medicare UPIN
NY0547T1Medicare ID - Type Unspecified