Provider Demographics
NPI:1760884480
Name:STONE, ILENE P (MD)
Entity Type:Individual
Prefix:
First Name:ILENE
Middle Name:P
Last Name:STONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:45 S PARK PL
Mailing Address - Street 2:#259
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-3924
Mailing Address - Country:US
Mailing Address - Phone:908-490-0036
Mailing Address - Fax:908-490-0067
Practice Address - Street 1:45 S PARK PL
Practice Address - Street 2:#259
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-3924
Practice Address - Country:US
Practice Address - Phone:908-490-0036
Practice Address - Fax:908-490-0067
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05611600208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation