Provider Demographics
NPI:1255652376
Name:STUART A SACKSTEIN M.D.P.A.
Entity Type:Organization
Organization Name:STUART A SACKSTEIN M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:A
Authorized Official - Last Name:SACKSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-641-7727
Mailing Address - Street 1:707 WHITE HORSE PIKE
Mailing Address - Street 2:SUITE A-4
Mailing Address - City:ABSECON
Mailing Address - State:NJ
Mailing Address - Zip Code:08201-1458
Mailing Address - Country:US
Mailing Address - Phone:609-641-7727
Mailing Address - Fax:609-641-7769
Practice Address - Street 1:707 WHITE HORSE PIKE
Practice Address - Street 2:SUITE A-4
Practice Address - City:ABSECON
Practice Address - State:NJ
Practice Address - Zip Code:08201-1458
Practice Address - Country:US
Practice Address - Phone:609-641-7727
Practice Address - Fax:609-641-7769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-14
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA42256207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty