Smith, Stacy Douglas

Smith, Stacy Douglas is an sole proprietor health care provider with primary practice located at 80 Johnson Ave Shabazz, Newark NJ 07108. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Smith, Stacy Douglas can be contacted via phone (973) 744-4113.

Contact Information

Primary practice address
80 Johnson Ave Shabazz Newark NJ 07108
Phone: (973) 744-4113
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 25MT00037500 New Jersey

Profile Details

NPI number 1912262148
LBN Legal business name Smith, Stacy Douglas
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 13th, 2012
Last updated Jun 14th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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