Provider Demographics
NPI:1447365747
Name:KUPFERBERG, STEPHEN B (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:B
Last Name:KUPFERBERG
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 BEY LEA RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2978
Mailing Address - Country:US
Mailing Address - Phone:732-281-0100
Mailing Address - Fax:732-281-0400
Practice Address - Street 1:54 BEY LEA RD
Practice Address - Street 2:SUITE 3
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2978
Practice Address - Country:US
Practice Address - Phone:732-281-0100
Practice Address - Fax:732-281-0400
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07280500174400000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJJ38717OtherHEALTHNET
NJ040017410OtherRAILROAD MEDICARE
NJJ38717OtherHEALTHNET
NJ040017410OtherRAILROAD MEDICARE
NJ060045Medicare ID - Type UnspecifiedMEDICARE GROUP