Provider Demographics
NPI:1801926449
Name:STEFANIK, CHERYL (BSN,)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:STEFANIK
Suffix:
Gender:F
Credentials:BSN,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 EL TORO DR
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-2337
Mailing Address - Country:US
Mailing Address - Phone:860-922-8864
Mailing Address - Fax:860-882-1885
Practice Address - Street 1:999 ASYLUM AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-2416
Practice Address - Country:US
Practice Address - Phone:860-882-0000
Practice Address - Fax:860-882-1885
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTR22179163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health