Provider Demographics
NPI:1982285094
Name:STECENKOVA, SVETLANA (RN)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:STECENKOVA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 ROLLING RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1540
Mailing Address - Country:US
Mailing Address - Phone:201-634-8404
Mailing Address - Fax:201-967-5529
Practice Address - Street 1:1 VETERANS WAY
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4100
Practice Address - Country:US
Practice Address - Phone:201-634-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR13471900163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJX3HZN68908360OtherNJ BCBS