Provider Demographics
NPI:1346380391
Name:STEPHANIE L. DOYLE, M.D., P.C.
Entity type:Organization
Organization Name:STEPHANIE L. DOYLE, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-931-3240
Mailing Address - Street 1:19 E KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:MOUNT EPHRAIM
Mailing Address - State:NJ
Mailing Address - Zip Code:08059-1338
Mailing Address - Country:US
Mailing Address - Phone:856-931-3240
Mailing Address - Fax:
Practice Address - Street 1:19 E KINGS HWY
Practice Address - Street 2:
Practice Address - City:MOUNT EPHRAIM
Practice Address - State:NJ
Practice Address - Zip Code:08059-1338
Practice Address - Country:US
Practice Address - Phone:856-931-3240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA063016207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7318707Medicaid
NJ7318707Medicaid
G54646Medicare UPIN