Provider Demographics
NPI:1386270890
Name:STRESS CARE MEDICAL GROUP
Entity type:Organization
Organization Name:STRESS CARE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SMUKLAVSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-679-4500
Mailing Address - Street 1:PO BOX 612
Mailing Address - Street 2:
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-0612
Mailing Address - Country:US
Mailing Address - Phone:732-679-4500
Mailing Address - Fax:732-679-4549
Practice Address - Street 1:500 PARK AVE
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8375
Practice Address - Country:US
Practice Address - Phone:732-679-4500
Practice Address - Fax:732-679-4549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty