Staback, Jason
Staback, Jason is an individual health care provider with primary practice located at 17644 Coastal Hwy #6 , Lewes DE 19958. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Staback, Jason can be contacted via phone (877) 425-7756.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 25MP00051300 | New Jersey |
Profile Details
| NPI number | 1750331948 |
|---|---|
| LBN Legal business name | Staback, Jason |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 11th, 2006 |
| Last updated | Apr 10th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750331948 | NPPES |
| New Jersey | Other | 320525 | AMERICAID/AMERIGROUP |
| New Jersey | Other | 0161662 | AMERICAID/AMERIGROUP |
| New Jersey | Other | 3K5491 | AMERICAID/AMERIGROUP |
Popular Providers
-
Blackhart, Bret S
640 W Moana Ln Ste 2, Reno NV 89509-4857 -
Gette, Michael T
2201 Forest Hills Dr , Harrisburg PA 17112-1089 -
Biren, Catherine A
1324 Nelson Ave Ste B, Modesto CA 95350-5341 -
Muffelman, David W
6790 Wood Ridge Drive , Gloucester VA 23061 -
Rosenfeld, Thomas Lee
5 Neponset St , Worcester MA 01606-2714 -
Stone, Stephen P
751 N Rutledge St Suite 2300, Springfield IL 62702-4909 -
Albregts, Anthony E
640 W Moana Ln , Reno NV 89509-4997 -
John, Michael D
620 W 15Th St , Edmond OK 73013-3617