Individual
CAROLE ANNE BURG STEVENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1914
(201) 996-4614
Mailing address
9 EDGEWATER PL, EDGEWATER, NJ 07020-1205
(281) 451-8380
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
014811-1
NY
363A00000X
Physician Assistant
Primary
25MP00255100
NJ
363A00000X
Physician Assistant
PA07801
TX
Other
Enumeration date
04/29/2011
Last updated
05/13/2014
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