Provider Demographics
NPI:1396742086
Name:MAFFEI, STEVEN A (DPM)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:MAFFEI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 NAMI LN
Mailing Address - Street 2:STE 1
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1251
Mailing Address - Country:US
Mailing Address - Phone:609-587-4100
Mailing Address - Fax:609-587-3278
Practice Address - Street 1:1 NAMI LN
Practice Address - Street 2:STE 1
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-1251
Practice Address - Country:US
Practice Address - Phone:609-587-4100
Practice Address - Fax:609-587-3278
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD00155700213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1662503Medicaid
NJ453492Medicare ID - Type Unspecified
T45336Medicare UPIN