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Individual

STEFAN H. FADERL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
92 SECOND ST., HACKENSACK, NJ 07601
(551) 996-3925
(551) 996-0574
Mailing address
100 FIRST ST., SUITE 301, HACKENSACK, NJ 07601
(551) 996-3925
(551) 996-0574

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
25MA09307400
NJ
207RX0202X
Medical Oncology Physician
K7015
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
043181901
TX
01
84682X
BCBS
TX
01
900002759
RR MEDICARE
TX
Enumeration date
09/15/2006
Last updated
11/21/2013
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