Provider Demographics
NPI:1528420189
Name:STADELMAN, ELENA A (APN-BC, NP-C)
Entity type:Individual
Prefix:MS
First Name:ELENA
Middle Name:A
Last Name:STADELMAN
Suffix:
Gender:F
Credentials:APN-BC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 E VENICE AVE
Mailing Address - Street 2:STE 210
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-9084
Mailing Address - Country:US
Mailing Address - Phone:941-584-6272
Mailing Address - Fax:941-584-6279
Practice Address - Street 1:38 MEADOWLANDS PKWY
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-2925
Practice Address - Country:US
Practice Address - Phone:201-863-3346
Practice Address - Fax:201-293-0402
Is Sole Proprietor?:No
Enumeration Date:2016-03-23
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00500100363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health