Provider Demographics
NPI:1033202882
Name:ORTEGA, STEPHANIE LYNN SCHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LYNN SCHAM
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BRANDYWINE CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848-3803
Mailing Address - Country:US
Mailing Address - Phone:973-625-6511
Mailing Address - Fax:973-983-2293
Practice Address - Street 1:25 POCONO RD
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2954
Practice Address - Country:US
Practice Address - Phone:973-625-6511
Practice Address - Fax:973-983-2293
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 70013207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8206805Medicaid
NJ037529Medicare ID - Type UnspecifiedDENVILLE CAMPUS
NJ037532Medicare ID - Type UnspecifiedSUSSEX CAMPUS
NJ8206805Medicaid
NJG45278Medicare UPIN
930118061Medicare PIN