Provider Demographics
NPI:1285029272
Name:STEFANSKI-PASCALE, KAREN (CN)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:STEFANSKI-PASCALE
Suffix:
Gender:F
Credentials:CN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHANNEL DR
Mailing Address - Street 2:UNIT 312
Mailing Address - City:MONMOUTH BEACH
Mailing Address - State:NJ
Mailing Address - Zip Code:07750-1365
Mailing Address - Country:US
Mailing Address - Phone:732-673-7114
Mailing Address - Fax:
Practice Address - Street 1:1 CHANNEL DR
Practice Address - Street 2:UNIT 312
Practice Address - City:MONMOUTH BEACH
Practice Address - State:NJ
Practice Address - Zip Code:07750-1365
Practice Address - Country:US
Practice Address - Phone:732-673-7114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0001847133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist