Provider Demographics
NPI:1134129125
Name:KABEL, STEPHEN EVAN (D O)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:EVAN
Last Name:KABEL
Suffix:
Gender:M
Credentials:D O
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 HAINES MILL RD
Mailing Address - Street 2:
Mailing Address - City:DELRAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-1715
Mailing Address - Country:US
Mailing Address - Phone:856-461-6200
Mailing Address - Fax:856-461-4013
Practice Address - Street 1:26 HAINES MILL RD
Practice Address - Street 2:
Practice Address - City:DELRAN
Practice Address - State:NJ
Practice Address - Zip Code:08075-1715
Practice Address - Country:US
Practice Address - Phone:856-461-6200
Practice Address - Fax:856-461-4013
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-30
Last Update Date:2007-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB053566207Q00000X
VA0102049854207Q00000X, 207R00000X
NJ25MB055637207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1834918OtherUNITED HEALTHCARE
NJ1K7341OtherHEALTHNET
NJP2191369OtherOXFORD
NJ24283OtherUNIVERSITY HEALTH PLAN
NJ0812422001OtherAMERIHEALTH HMO
NJ2255682OtherAETNA
NJ4122929OtherCIGNA
NJ110230350OtherRAIL ROAD MEDICARE NUMBER
NJ1937276OtherFIRST HEALTH
NJ9001905Medicaid
NJ2595958OtherGHI
NJ908306OtherAMERIHEALTH PPO
NJG62878Medicare UPIN
NJ036923Medicare ID - Type Unspecified