Provider Demographics
NPI:1114968781
Name:STONE, JANE ELLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:ELLEN
Last Name:STONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:163 ENGLE ST
Mailing Address - Street 2:SUITE 1-C
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2535
Mailing Address - Country:US
Mailing Address - Phone:201-569-2520
Mailing Address - Fax:201-569-8703
Practice Address - Street 1:163 ENGLE ST
Practice Address - Street 2:SUITE 1-C
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2535
Practice Address - Country:US
Practice Address - Phone:201-569-2520
Practice Address - Fax:201-569-8703
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04471400207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJCO4480Medicare UPIN
NJST448539Medicare ID - Type Unspecified