Provider Demographics
NPI:1649213422
Name:GEFFNER, STUART R (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:R
Last Name:GEFFNER
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 1:94 OLD SHORT HILLS RD
Mailing Address - Street 2:EAST WING, SUITE 305
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5672
Mailing Address - Country:US
Mailing Address - Phone:973-322-9801
Mailing Address - Fax:973-322-9807
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:EAST WING, SUITE 305
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-9801
Practice Address - Fax:973-322-9807
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05451600174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF91966Medicare UPIN