Provider Demographics
NPI:1912279480
Name:JOSEPH P. STUBEL M.D. P.C
Entity type:Organization
Organization Name:JOSEPH P. STUBEL M.D. P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:STUBEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-979-9400
Mailing Address - Street 1:521 ROUTE 111
Mailing Address - Street 2:SUITE 206
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-4370
Mailing Address - Country:US
Mailing Address - Phone:631-979-9400
Mailing Address - Fax:631-979-9562
Practice Address - Street 1:521 ROUTE 111
Practice Address - Street 2:SUITE 206
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-4370
Practice Address - Country:US
Practice Address - Phone:631-979-9400
Practice Address - Fax:631-979-9562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY121840207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty