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General NPI Number Information
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NPI Number | 1689770844
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Entity Type | Individual
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Provider Name | STEFAN H. FADERL M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 11/21/2013
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Provider Practice Location Address
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Address Line | 92 SECOND ST.
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City | HACKENSACK
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State | NJ
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Zip | 07601
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Country | US
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Telephone | 551-996-3925
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Fax | 551-996-0574
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Provider Business Mailing Address
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Address Line | 100 FIRST ST. SUITE 301
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City | HACKENSACK
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State | NJ
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Zip | 07601
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Country | US
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Telephone | 551-996-3925
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Fax | 551-996-0574
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | K7015
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 25MA09307400
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License Number State | NJ
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