Provider Demographics
NPI:1407852676
Name:ZRADA, STEPHEN EUGENE (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:EUGENE
Last Name:ZRADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 ROUTE 70 E
Mailing Address - Street 2:STE V107
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-4212
Mailing Address - Country:US
Mailing Address - Phone:856-424-3311
Mailing Address - Fax:856-489-0888
Practice Address - Street 1:1930 ROUTE 70 E
Practice Address - Street 2:STE V107
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-4212
Practice Address - Country:US
Practice Address - Phone:856-424-3311
Practice Address - Fax:856-424-5634
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07352100207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8725501Medicaid
H53225Medicare UPIN
NJ8725501Medicaid