Provider Demographics
NPI:1710101134
Name:KAREN STAGE OPDYKE, MD, PC
Entity Type:Organization
Organization Name:KAREN STAGE OPDYKE, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:STAGE
Authorized Official - Last Name:OPDYKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-303-6123
Mailing Address - Street 1:PO BOX 254
Mailing Address - Street 2:
Mailing Address - City:OLDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08858-0254
Mailing Address - Country:US
Mailing Address - Phone:800-438-3206
Mailing Address - Fax:866-935-9166
Practice Address - Street 1:152 OLDWICK RD.
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE STATION
Practice Address - State:NJ
Practice Address - Zip Code:08889
Practice Address - Country:US
Practice Address - Phone:800-438-3206
Practice Address - Fax:866-935-9166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA076492002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty