Basic Information
Provider Information
NPI: 1306103635
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VANPELT
FirstName: STEPHEN
MiddleName: ROBERT
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 MADISON AVE
Address2: DEPARTMENT OF EMERGENCY MEDICINE
City: MORRISTOWN
State: NJ
PostalCode: 079606136
CountryCode: US
TelephoneNumber: 9739715000
FaxNumber:  
Practice Location
Address1: 100 MADISON AVE
Address2: DEPARTMENT OF EMERGENCY MEDICINE
City: MORRISTOWN
State: NJ
PostalCode: 079606136
CountryCode: US
TelephoneNumber: 9739715000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/11/2012
LastUpdateDate: 04/11/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X25MA09073100NJY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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