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General NPI Number Information
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NPI Number | 1699113480
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Entity Type | Individual
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Provider Name | STEPHANIE JARAMILLO PA
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Gender | Female
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Dates
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Enumeration Date | 06/13/2013
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 111 CENTRAL AVE
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City | NEWARK
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State | NJ
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Zip | 07102-1909
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Country | US
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Telephone | 800-893-9698
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Fax |
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Provider Business Mailing Address
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Address Line | 328 WASHINGTON PL
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-3230
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Country | US
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Telephone | 201-783-3353
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00308800
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License Number State | NJ
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