Healthcare Provider Details

I. General information

NPI: 1528989050
Provider Name (Legal Business Name): STEPHANIE PARM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 WALNUT AVE STE 200
CLARK NJ
07066-1647
US

IV. Provider business mailing address

216 HILLSIDE TER
IRVINGTON NJ
07111-1431
US

V. Phone/Fax

Practice location:
  • Phone: 862-220-7159
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: