Provider Demographics
NPI:1053772327
Name:STAGES WOUND HEALING LLC
Entity type:Organization
Organization Name:STAGES WOUND HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALDO
Authorized Official - Middle Name:RAMOS
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-812-3177
Mailing Address - Street 1:9 CONCORD WAY
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950
Mailing Address - Country:US
Mailing Address - Phone:862-812-3177
Mailing Address - Fax:
Practice Address - Street 1:9 CONCORD WAY
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950
Practice Address - Country:US
Practice Address - Phone:862-812-3177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STAGES WOUND HEALING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty