Provider Demographics
NPI:1194935965
Name:STAPLETON, DRUE THADDEUS (PHD, ATC, CSCS)
Entity type:Individual
Prefix:DR
First Name:DRUE
Middle Name:THADDEUS
Last Name:STAPLETON
Suffix:
Gender:M
Credentials:PHD, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SKILLMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2917
Mailing Address - Country:US
Mailing Address - Phone:609-895-5426
Mailing Address - Fax:
Practice Address - Street 1:2083 LAWRENCEVILLE RD
Practice Address - Street 2:RIDER UNIVERSITY
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-3001
Practice Address - Country:US
Practice Address - Phone:609-895-5426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer