Provider Demographics
NPI:1457572505
Name:KARDOS, STEPHEN ALLEN (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ALLEN
Last Name:KARDOS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SAILERS WAY
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760
Mailing Address - Country:US
Mailing Address - Phone:732-576-8090
Mailing Address - Fax:
Practice Address - Street 1:17 SAILERS WAY
Practice Address - Street 2:
Practice Address - City:RUMSON
Practice Address - State:NJ
Practice Address - Zip Code:07760
Practice Address - Country:US
Practice Address - Phone:732-997-9660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB023191002080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine