Provider Demographics
NPI:1437101391
Name:MURRAY-TAYLOR, STACEY O (MD)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:O
Last Name:MURRAY-TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:STACEY
Other - Middle Name:ODELL
Other - Last Name:MURRAY-TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 13700-0135
Mailing Address - Street 2:NEWARK BETH ISRAEL EMERGENCY ROOM DEPARTMENT
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19191-0135
Mailing Address - Country:US
Mailing Address - Phone:610-668-6491
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:201 LYONS AVENUE
Practice Address - Street 2:NEWARK BETH ISRAEL MEDICAL CENTER
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2094
Practice Address - Country:US
Practice Address - Phone:973-926-7000
Practice Address - Fax:610-617-6280
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07118500207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H29596Medicare UPIN
NJ044096Medicare ID - Type Unspecified