Provider Demographics
NPI:1487656013
Name:SARGENT, STEPHANIE CHRISTINE (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:CHRISTINE
Last Name:SARGENT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:CHRISTIN
Other - Last Name:SARGENT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:151 FRIES MILL RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2016
Mailing Address - Country:US
Mailing Address - Phone:856-401-9300
Mailing Address - Fax:856-374-5805
Practice Address - Street 1:151 FRIES MILL RD
Practice Address - Street 2:SUITE 400
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2016
Practice Address - Country:US
Practice Address - Phone:856-401-9300
Practice Address - Fax:856-374-5805
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB07852300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I31475Medicare UPIN
091568Medicare ID - Type Unspecified