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General NPI Number Information
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NPI Number | 1811019201
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Entity Type | Individual
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Provider Name | AUDREY STEDFORD DNP
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Gender | Female
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 2035 RALPH AVE STE A8
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City | BROOKLYN
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State | NY
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Zip | 11234-5300
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Country | US
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Telephone | 646-631-9103
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Fax | 347-352-3238
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Provider Business Mailing Address
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Address Line | 966 E 102ND ST
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City | BROOKLYN
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State | NY
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Zip | 11236-2620
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Country | US
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Telephone | 646-631-9103
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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 | 303562
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License Number State | NY
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