Provider Demographics
NPI:1255104642
Name:VOGEL, STEPHANIE (LMT,)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:VOGEL
Suffix:
Gender:F
Credentials:LMT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 WHILDAM AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-3161
Mailing Address - Country:US
Mailing Address - Phone:267-251-3462
Mailing Address - Fax:
Practice Address - Street 1:109 SUNSET BLVD FL 2
Practice Address - Street 2:
Practice Address - City:WEST CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-4140
Practice Address - Country:US
Practice Address - Phone:267-251-3462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00096800225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0450418203Other01