Healthcare Provider Details

I. General information

NPI: 1558722322
Provider Name (Legal Business Name): SEFAKOR ATADJA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2016
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVE
MORRISTOWN NJ
07960-6136
US

IV. Provider business mailing address

100 MADISON AVE
MORRISTOWN NJ
07960-6136
US

V. Phone/Fax

Practice location:
  • Phone: 973-388-3969
  • Fax:
Mailing address:
  • Phone: 516-453-0435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00391900
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number021118
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: