Provider Demographics
NPI:1265517999
Name:PARAGIOUDAKIS, STEVE JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:JOHN
Last Name:PARAGIOUDAKIS
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 1:1131 BROAD STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4329
Mailing Address - Country:US
Mailing Address - Phone:732-380-1212
Mailing Address - Fax:732-380-1372
Practice Address - Street 1:1131 BROAD STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4329
Practice Address - Country:US
Practice Address - Phone:732-380-1212
Practice Address - Fax:732-380-1372
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA063102207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8184909Medicaid
NJ8184909Medicaid
G82985Medicare UPIN