JACQUELYN S STATHIS (NPI# 1124591052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124591052 |
| Entity Type | Individual |
| Full Name | JACQUELYN S STATHIS |
| Credential | NP |
| Practice Address |
5301 Broadway West New York NJ 07093-2622 |
| Practice Telephone | 2018669320 |
| Mailing Telephone | 2012100200 |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2020-10-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
26NJ00814500 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5301 BROADWAY |
| City | WEST NEW YORK |
| State | NJ |
| Zip Code | 07093-2622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306810213 | Debra Roma-distefano | Nurse Practitioner | 5301 Broadway, West New York, NJ 07093-2622 | 2006-02-15 |
| 1407466048 | Patricia Mary Boyce | Nurse Practitioner | 5301 Broadway, West New York, NJ 07093-2622 | 2020-08-07 |
| 1215567409 | Danny Tamayo | Nurse Practitioner | 5301 Broadway, West New York, NJ 07093-2622 | 2020-01-16 |
| 1912545112 | Elizabeth Sasso-karelitsky | Dietitian, Registered | 5301 Broadway, West New York, NJ 07093-2622 | 2019-12-18 |
| 1952954398 | Kassandra Lynn Kayal | Nurse Practitioner | 5301 Broadway, West New York, NJ 07093-2622 | 2019-07-23 |
| 1629528914 | Cardinal Health 132 LLC | Pharmacy | 5301 Broadway, West New York, NJ 07093-2622 | 2016-10-11 |
| 1871929885 | Ololade F Akinronbi | Nurse Practitioner | 5301 Broadway, West New York, NJ 07093-2622 | 2013-09-23 |
| 1891049490 | Velma Asneth Frasier | Nurse Practitioner | 5301 Broadway, West New York, NJ 07093-2622 | 2012-11-04 |
| 1265707863 | Lybia Burgos | Nurse Practitioner | 5301 Broadway, West New York, NJ 07093-2622 | 2012-03-14 |
| 1043584378 | Lucia Jacqueline Knapp | Counselor | 5301 Broadway, West New York, NJ 07093-2622 | 2012-03-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745225 | Denmari Berberabe | Physical Therapist | 6000 John F. Kennedy Boulevard, West New York, NJ 07093 | 2020-09-16 |
| 1801409321 | William T Chen | Pharmacist | 6012 Kennedy Boulevard, West New York, NJ 07093 | 2020-08-25 |
| 1598374050 | Benita Strickland | Physical Therapy Assistant | 6000 John F. Kennedy Blvd, West New York, NJ 07093 | 2020-07-30 |
| 1053964809 | Santvana Vyas | Dentist | 6020 Broadway, Fl#2, West New York, NJ 07093 | 2019-07-22 |
| 1043875552 | Natalya V Fryazin | Counselor | 444 60th St., 2nd Flr, West New York, NJ 07093 | 2019-05-09 |
| 1558844209 | Merrideth Kennedy | Occupational Therapist | 6612-18 Bergenline Ave, West New York, NJ 07093 | 2018-09-10 |
| 1578072385 | Allied Healthcare Diagnostics | Radiology | 560 60th Street, Suite A, West New York, NJ 07093 | 2017-09-25 |
| 1265889695 | Bilingual Counseling Services, LLC | Community/Behavioral Health | 574 67th Street, Apt 2, West New York, NJ 07093 | 2016-05-16 |
| 1083079297 | Dino Pascual | Registered Nurse | 25 Port Imperial Avenue, Apt. 111, West New York, NJ 07093 | 2015-12-15 |
| 1992179469 | Diane A Doucet | Behavioral Analyst | 140 65th St, Apt 1, West New York, NJ 07093 | 2015-11-21 |
| Find all providers in zip 07093 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205395506 | Jessica Aristizabal | Nurse Practitioner | 26 Ave At Port Imperial Apt 227, West New York, NJ 07093-8392 | 2019-03-16 |
| 1861680332 | Maria Giuseppina Dibiase | Nurse Practitioner | 5207 Blvd East, West New York, NJ 07093-3507 | 2007-10-10 |
| 1891049490 | Velma Asneth Frasier | Nurse Practitioner | 5301 Broadway, West New York, NJ 07093-2622 | 2012-11-04 |
| 1811222581 | Valerie Lynn Schleck | Nurse Practitioner | 6701 Bergenline Ave, West New York, NJ 07093-1704 | 2009-10-13 |
| 1184662462 | Kathleen Nora Cahill | Nurse Practitioner | 5301 Broadway, West New York, NJ 07093-2622 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275133175 | Kristy Liekfet | Nurse Practitioner | Atlanticare Apg Palliative Care, 1925 Pacific Ave. 1st Flr, Atlantic City, NJ 08401 | 2020-10-29 |
| 1609476761 | Remya Uthup | Nurse Practitioner | 240 Main St Apt 418, Hackensack, NJ 07601-5745 | 2020-10-28 |
| 1083213524 | Joann Michelle Munoz | Nurse Practitioner | 11 Highland Pl, Ridgefield Park, NJ 07660-1203 | 2020-10-24 |
| 1669071775 | Destiny Medical Practice LLC | Nurse Practitioner | 10 Amara Ln, Westampton, NJ 08060-5753 | 2020-10-20 |
| 1912505918 | Lamercie Brasier | Nurse Practitioner | 55 Valley Way, West Orange, NJ 07052-5829 | 2020-10-12 |
| 1568069912 | Christine B Adams | Nurse Practitioner | 75 Lane Rd, Fairfield, NJ 07004-1044 | 2020-10-07 |
| 1255938361 | Maryjoy Marzan | Nurse Practitioner | Hope Tower - Jersey Shore University Medical Center, 19 Davis St 6th Floor, Neptune, NJ 07753 | 2020-10-02 |
| 1235746553 | Ellen Smith | Nurse Practitioner | 340 Airis Dr., Suite 203, Newark, NJ 07114 | 2020-09-30 |
| 1861009342 | Maria Angela Flores | Nurse Practitioner | 482 William Way N, Wyckoff, NJ 07481-1722 | 2020-09-28 |
| 1437764545 | Alison O'neill | Nurse Practitioner | 720 Monroe St Ste E407, Hoboken, NJ 07030-6356 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | WEST NEW YORK |
| Zip Code | 07093 |
Please comment or provide details below to improve the information on JACQUELYN S STATHIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.