Healthcare Provider Details

I. General information

NPI: 1932704509
Provider Name (Legal Business Name): STEPHEN A ADJEI FNP, NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 10/16/2022
Certification Date: 10/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 REYNOLDS TER APT 4N
ORANGE NJ
07050-3334
US

IV. Provider business mailing address

459 PASSAIC AVE
WEST CALDWELL NJ
07006-7457
US

V. Phone/Fax

Practice location:
  • Phone: 973-413-0235
  • Fax:
Mailing address:
  • Phone: 973-276-3026
  • Fax: 862-702-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number26NR14799800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ01104100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: