STC PEDIATRICS LLC NPI 1194369504

NPI Information

NPI: 1194369504
Provider Name: STC PEDIATRICS LLC
Classification: Plastic Surgery - 208200000X
Entity Type: Organization
:
Address: 100 KINGS WAY E STE C
SEWELL, NJ
ZIP 08080
Phone: (856) 582-0644

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NPI Details

STC PEDIATRICS LLC is a plastic surgery in Sewell, NJ. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. STC PEDIATRICS LLC NPI is 1194369504. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

100 KINGS WAY E STE C
SEWELL, NJ
ZIP 08080-238
Phone: (856) 582-0644

The provider's authorized official is Brian Rayme .
The authorized official title is Evp & Cfo and has the following contact phone number (484) 628-1324.

The enumeration date for this NPI number is 10/30/2019 and was last updated on 11/6/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	208000000X	Pediatrics		No
2	2086S0122X	Surgery	Plastic and Reconstructive Surgery	No
3	2086S0120X	Surgery	Pediatric Surgery	No
4	208200000X	Plastic Surgery		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0721212	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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