1801296769 NPI number — STEPHANIE MARANO MSN,APN,FNP-BC,CMSRN

Table of content: STEPHANIE MARANO MSN,APN,FNP-BC,CMSRN (NPI 1801296769)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801296769 NPI number — STEPHANIE MARANO MSN,APN,FNP-BC,CMSRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARANO
Provider First Name:
STEPHANIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN,APN,FNP-BC,CMSRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MARANO
Provider Other First Name:
STEPHANIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
BSN,RN,CMSRN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801296769
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/04/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1580 LAKEWOOD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOMS RIVER
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08755-3287
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-244-4700
Provider Business Mailing Address Fax Number:
732-244-8482

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 TILTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08225-1270
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-337-6663
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/28/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  SP014133 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)