Provider Demographics
NPI:1679645261
Name:STEFANELLI, PAUL FRANK (DCDACNB)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:FRANK
Last Name:STEFANELLI
Suffix:
Gender:M
Credentials:DCDACNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1540
Mailing Address - Country:US
Mailing Address - Phone:973-450-1003
Mailing Address - Fax:973-450-5302
Practice Address - Street 1:567 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1540
Practice Address - Country:US
Practice Address - Phone:973-450-1003
Practice Address - Fax:973-450-5302
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMCO3344111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ000450459Medicare ID - Type UnspecifiedPROVIDER #