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General NPI Number Information
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NPI Number | 1689748600
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Entity Type | Individual
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Provider Name | RICHARD GEBRIEL STEFANACCI DO
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 600 S 43RD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4418
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Country | US
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Telephone | 215-596-7466
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W MAPLE AVE
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City | MERCHANTVILLE
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State | NJ
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Zip | 08109-2032
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Country | US
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Telephone | 215-266-7509
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | OS007774L
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License Number State | PA
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