NPI 1093052102
Stafford Medical PA
Practice location
- Address
- 1364 Route 72 W 2, Manahawkin, NJ 08050-2485
- Phone
- (609) 597-3416
- Mailing address
- 5626 Oberlin Dr 110, San Diego, CA 92121-1705
Authorised official
- Name
- Kenny Heine
- Title
- Vp Ops
- Phone
- (858) 964-1506
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1093052102
- Entity type
- Organization
- NPI issued
- 9 Jan 2013
- Record last updated
- 9 Jan 2013
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.