Individual
STEPHANIE JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
64 UNION AVE APT 501, IRVINGTON, NJ 07111-5201
(347) 317-9686
Mailing address
64 UNION AVE APT 501, IRVINGTON, NJ 07111
(347) 317-9686
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10 311429
NY
Other
Enumeration date
10/31/2012
Last updated
10/31/2012
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