Provider Demographics
NPI:1396749321
Name:STOLMAN, LEWIS PETER (MD)
Entity type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:PETER
Last Name:STOLMAN
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 1:347 MOUNT PLEASANT AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-2744
Mailing Address - Country:US
Mailing Address - Phone:973-740-0101
Mailing Address - Fax:973-740-0103
Practice Address - Street 1:347 MOUNT PLEASANT AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2744
Practice Address - Country:US
Practice Address - Phone:973-740-0101
Practice Address - Fax:973-740-0103
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02387300207N00000X
NJ25 MA02387300207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C52753Medicare UPIN
ST44806Medicare ID - Type Unspecified