Doctor Name: | STEPHANIE RODRIGUEZ WOLLMAN |
NPI Number: | 1033547427 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ANP-C |
License Number: | 26NJ00059500 |
Business Practice Address: | 94 Old Short Hills Rd Livingston, NJ - 070395672 |
Business Phone Number: | 9733226450 |
Business Fax Number: | |
Mailing Address: | 53 Hunter Ave, FANWOOD |
State: | NJ |
Postal Code: | 070231246 |
Phone Number: | 9084901113 |
Fax Number: | |
NPI Enumeration Date: | 10/22/2013 |
NPI Last Update Date: | 10/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 26NJ00059500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |