Provider Demographics
NPI:1629023478
Name:SZWED, STANLEY (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:
Last Name:SZWED
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 1:925 CLIFTON AVE
Mailing Address - Street 2:SUITE# 108
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2724
Mailing Address - Country:US
Mailing Address - Phone:973-471-6200
Mailing Address - Fax:973-471-6221
Practice Address - Street 1:925 CLIFTON AVE
Practice Address - Street 2:SUITE# 108
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2724
Practice Address - Country:US
Practice Address - Phone:973-471-6200
Practice Address - Fax:973-471-6221
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA473740207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1834509Medicaid
NJC60988Medicare UPIN
NJ544985Medicare ID - Type Unspecified