Healthcare Provider Details

I. General information

NPI: 1902536907
Provider Name (Legal Business Name): STEPHANIE ESPEJO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2022
Last Update Date: 08/15/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 WASHINGTON STREET
HOBOKEN NJ
07030
US

IV. Provider business mailing address

74 WASHINGTON STREET
HOBOKEN NJ
07030
US

V. Phone/Fax

Practice location:
  • Phone: 201-292-5445
  • Fax:
Mailing address:
  • Phone: 201-292-5445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA12766700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: