Individual
STEFANIE M PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3143 BROADWAY APT 1C, NEW YORK, NY 10027-4107
(912) 398-8777
Mailing address
7901 BROADWAY, ELMHURST, NY 11373-1329
(718) 334-4000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
022842
NY
363AM0700X
Medical Physician Assistant
Primary
022842
NY
Other
Enumeration date
06/13/2017
Last updated
02/02/2019
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