Provider Demographics
NPI:1538193156
Name:MOLDEN, STEPHANIE MARIE (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIE
Last Name:MOLDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:MARIE
Other - Last Name:SALTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:760 NEWTOWN YARDLEY RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-4500
Mailing Address - Country:US
Mailing Address - Phone:215-504-8900
Mailing Address - Fax:215-504-8902
Practice Address - Street 1:760 NEWTOWN YARDLEY RD
Practice Address - Street 2:SUITE 115
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4500
Practice Address - Country:US
Practice Address - Phone:215-504-8900
Practice Address - Fax:215-504-8902
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425334207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00426292OtherRAILROAD MEDICARE
PA2052999000OtherINDEPENDENCE BLUE CROSS
PA1360068OtherHIGHMARK BLUE SHIELD
PA03233300OtherCAPITAL BLUE CROSS
PA1084443OtherAETNA
PA1084443OtherAETNA