Provider Demographics
NPI:1891717708
Name:ABO, STEPHEN M (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:ABO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:713 GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090
Mailing Address - Country:US
Mailing Address - Phone:973-877-2829
Mailing Address - Fax:973-877-2964
Practice Address - Street 1:111 CENTRAL AVE.
Practice Address - Street 2:CANCER CENTER
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102
Practice Address - Country:US
Practice Address - Phone:973-877-2829
Practice Address - Fax:973-877-2964
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2014-06-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB07545100207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0119628Medicaid
NJ109057Medicare ID - Type Unspecified