Provider Demographics
NPI:1164585659
Name:KAPLAN, STACY (DO)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 EWING ST
Mailing Address - Street 2:SUITE B-17
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2757
Mailing Address - Country:US
Mailing Address - Phone:609-688-8800
Mailing Address - Fax:609-688-8801
Practice Address - Street 1:601 EWING ST
Practice Address - Street 2:SUITE B-17
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2757
Practice Address - Country:US
Practice Address - Phone:609-688-8800
Practice Address - Fax:609-688-8801
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB707332086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ037708Medicare ID - Type Unspecified