Provider Demographics
NPI:1578917753
Name:JAEGER, STEPHEN JOSPEH JR (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOSPEH
Last Name:JAEGER
Suffix:JR
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 1:4 SWIMMING RIVER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LINCROFT
Mailing Address - State:NJ
Mailing Address - Zip Code:07738-1727
Mailing Address - Country:US
Mailing Address - Phone:646-708-3846
Mailing Address - Fax:
Practice Address - Street 1:4 SWIMMING RIVER RD STE 101
Practice Address - Street 2:
Practice Address - City:LINCROFT
Practice Address - State:NJ
Practice Address - Zip Code:07738-1727
Practice Address - Country:US
Practice Address - Phone:646-708-3846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT615952084P0800X
390200000X
NJ25MA108002002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program