Provider Demographics
NPI:1619989712
Name:MCILVEEN, STEPHEN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:MCILVEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:ONE WEST RIDGEWOOD AVENUE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-670-6702
Mailing Address - Fax:201-447-7098
Practice Address - Street 1:ONE WEST RIDGEWOOD AVENUE
Practice Address - Street 2:SUITE 307
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-670-6702
Practice Address - Fax:201-447-7098
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA58444207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B10520Medicare UPIN
NJ100115Medicare PIN