Doctor Name: | MRS. STEPHANIE MARUCCI |
NPI Number: | 1801262704 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 26NJ00584400 |
Business Practice Address: | 129 Giammarino Ave Gibbstown, NJ - 080271311 |
Business Phone Number: | 6096800005 |
Business Fax Number: | |
Mailing Address: | 129 Giammarino Ave, GIBBSTOWN |
State: | NJ |
Postal Code: | 080271311 |
Phone Number: | 6096800005 |
Fax Number: | |
NPI Enumeration Date: | 08/13/2015 |
NPI Last Update Date: | 08/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 26NJ00584400 |
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: |