Healthcare Provider Details

I. General information

NPI: 1376417907
Provider Name (Legal Business Name): STEPHANIE BELCASTRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 STATE RT 94
VERNON NJ
07462-3557
US

IV. Provider business mailing address

PO BOX 95000, LB#7550
PHILADELPHIA PA
19195-7550
US

V. Phone/Fax

Practice location:
  • Phone: 973-827-7800
  • Fax: 973-209-7855
Mailing address:
  • Phone: 844-362-1735
  • Fax: 973-290-7495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ15389600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: