Healthcare Provider Details

I. General information

NPI: 1457422735
Provider Name (Legal Business Name): STEFANIE PERLE AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 TAYLORS MILLS RD SUITE 105B
MANALAPAN NJ
07726-3281
US

IV. Provider business mailing address

224 TAYLORS MILLS RD SUITE #105B
MANALAPAN NJ
07726-3281
US

V. Phone/Fax

Practice location:
  • Phone: 732-303-9660
  • Fax: 732-303-1810
Mailing address:
  • Phone: 732-462-8412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberYA000601
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberMG000984
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: