Provider Demographics
NPI:1386797645
Name:SPADAFINO, STEFANIE (PAC)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:SPADAFINO
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 S UNION AVE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2843
Mailing Address - Country:US
Mailing Address - Phone:908-272-8676
Mailing Address - Fax:908-272-7052
Practice Address - Street 1:501 IRONBRIDGE RD
Practice Address - Street 2:SU 10
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:732-431-2999
Practice Address - Fax:732-431-2993
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0797838HZMedicare ID - Type Unspecified
P31472Medicare UPIN