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General NPI Number Information
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NPI Number | 1619425410
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Entity Type | Individual
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Provider Name | STEPHEN F GOELLER JR. RN, FNP-BC, ENP-C
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Gender | Male
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 228 E ROUTE 59 # 144
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City | NANUET
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State | NY
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Zip | 10954-2905
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Country | US
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Telephone | 926-269-3020
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Fax |
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Provider Business Mailing Address
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Address Line | 228 E ROUTE 59 # 144
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City | NANUET
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State | NY
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Zip | 10954-2905
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Country | US
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Telephone | 929-269-3020
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 26NJ00712300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9226
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00712300
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F341571
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License Number State | NY
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