MEDICARE: STEPHANIE IANNARONE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	25MZ00101600	NJ

General Provider Information

NPI Number	:	1881023802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE IANNARONE

Provider Business Mailing Address
First Line	:	28 W HOLLYWOOD LN
Second Line	:
City	:	MARMORA
State	:	NJ
Zip	:	08223-1756
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6717 ATLANTIC AVE
Second Line	:
City	:	VENTNOR CITY
State	:	NJ
Zip	:	08406-2621
Country	:	US
Telephone Number	:	609-736-0510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2013
Last Update Date	:	11/12/2013

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Directions to “ STEPHANIE IANNARONE ” Practice Location

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