Healthcare Provider Details

I. General information

NPI: 1528424355
Provider Name (Legal Business Name): STEPHANIE AUCELLO APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2016
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 W SHERMAN AVE
VINELAND NJ
08360-6911
US

IV. Provider business mailing address

263 STAGGERBUSH RD
WILLIAMSTOWN NJ
08094-3914
US

V. Phone/Fax

Practice location:
  • Phone: 856-363-1000
  • Fax:
Mailing address:
  • Phone: 856-313-8018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00612600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: