Provider Demographics
NPI:1083154934
Name:LAMPROU, STEPHEN (DO)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:LAMPROU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 TAVISTOCK
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-4020
Mailing Address - Country:US
Mailing Address - Phone:856-296-4450
Mailing Address - Fax:
Practice Address - Street 1:1401 ATLANTIC AVE STE 2600
Practice Address - Street 2:
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-7001
Practice Address - Country:US
Practice Address - Phone:609-572-6055
Practice Address - Fax:609-572-6033
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-26
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB10755000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine