Provider Demographics
NPI:1740251040
Name:STEGMAN, DANIEL
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:STEGMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2247
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07015-2247
Mailing Address - Country:US
Mailing Address - Phone:973-546-5700
Mailing Address - Fax:973-546-8898
Practice Address - Street 1:403 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2642
Practice Address - Country:US
Practice Address - Phone:973-546-5700
Practice Address - Fax:973-546-8898
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06384900207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6941702Medicaid
NJ865303TCMMedicare PIN
NJ6941702Medicaid
NJG26414Medicare UPIN