Provider Demographics
NPI:1225109366
Name:STEIN, IRVING
Entity Type:Individual
Prefix:DR
First Name:IRVING
Middle Name:
Last Name:STEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HARTSHORNE RD
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-2539
Mailing Address - Country:US
Mailing Address - Phone:732-493-8246
Mailing Address - Fax:732-493-3404
Practice Address - Street 1:279 3RD AVE
Practice Address - Street 2:SUITE403
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6205
Practice Address - Country:US
Practice Address - Phone:732-222-7676
Practice Address - Fax:732-229-1863
Is Sole Proprietor?:No
Enumeration Date:2006-11-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB022302002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD80325Medicare UPIN
NJ041865BJ6Medicare ID - Type Unspecified