Individual
STEPHEN THOMAS SPANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 RIVERVIEW PLZ, RED BANK, NJ 07701-1864
(732) 530-2207
Mailing address
1 RIVERVIEW PLZ, RED BANK, NJ 07701-1864
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00202800
NJ
Other
Enumeration date
03/07/2007
Last updated
08/20/2012
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