Active NPI
Norman J Stack, VMD
- Veterinarian
- Maplewood, NJ
National Provider Identifier
1164745428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Veterinarian
- License
- 01167
- Practice address
- 2172 Millburn Ave
Maplewood, NJ 07040-2605 - Phone
- (973) 763-3445
- Fax
- (973) 763-2819
- NPI assigned
- Mar 1, 2010
- Last updated
- Mar 1, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 01167 | NJ | Primary |
Addresses
Primary practice location
2172 Millburn Ave
Maplewood, NJ 07040-2605
Mailing address
2172 Millburn Ave
Maplewood, NJ 07040-2605
Phone (973) 763-3445
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01167 | NJ | MD | Veterinarian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267401600000",
"number": "1164745428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2172 MILLBURN AVE",
"city": "MAPLEWOOD",
"state": "NJ",
"postal_code": "070402605",
"telephone_number": "973-763-3445",
"fax_number": "973-763-2819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2172 MILLBURN AVE",
"city": "MAPLEWOOD",
"state": "NJ",
"postal_code": "070402605",
"telephone_number": "973-763-3445",
"fax_number": "973-763-2819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACK",
"first_name": "NORMAN",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "VMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-01",
"last_updated": "2010-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "174M00000X",
"taxonomy_group": "",
"desc": "Veterinarian",
"state": "NJ",
"license": "01167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maplewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.