Provider Demographics
NPI:1497780894
Name:ESPINOSA, STEPHEN (RNFA)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 119
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-0119
Mailing Address - Country:US
Mailing Address - Phone:800-624-0792
Mailing Address - Fax:201-943-8105
Practice Address - Street 1:175 HIGH ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-1004
Practice Address - Country:US
Practice Address - Phone:973-383-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO10947800163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NO10947800OtherLICENSE