Provider Demographics
NPI:1851876601
Name:VATAJ, STEFANIE
Entity Type:Individual
Prefix:MS
First Name:STEFANIE
Middle Name:
Last Name:VATAJ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-2662
Mailing Address - Country:US
Mailing Address - Phone:914-494-9607
Mailing Address - Fax:
Practice Address - Street 1:224 PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-2662
Practice Address - Country:US
Practice Address - Phone:914-494-9607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist