Active NPI
Stephanie Pudalov, MD, MS
- Student in an Organized Health Care Education/Training Program
- Phillipsburg, NJ
National Provider Identifier
1003749490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 755 Memorial Pkwy Ste 300
Phillipsburg, NJ 08865-2748 - Phone
- (908) 847-3300
- NPI assigned
- Jun 4, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
755 Memorial Pkwy Ste 300
Phillipsburg, NJ 08865-2748
Mailing address
755 Memorial Pkwy Ste 300
Phillipsburg, NJ 08865-2748
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780531200000",
"number": "1003749490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 MEMORIAL PKWY STE 300",
"city": "PHILLIPSBURG",
"state": "NJ",
"postal_code": "088652748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 MEMORIAL PKWY STE 300",
"city": "PHILLIPSBURG",
"state": "NJ",
"postal_code": "088652748",
"telephone_number": "908-847-3300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUDALOV",
"first_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "MD, MS",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-06-04",
"last_updated": "2026-06-04",
"certification_date": "2026-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phillipsburg, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.