Provider Demographics
NPI:1902504863
Name:GOLDSTEIN, STEFANIE ALEXANDRA (RN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:ALEXANDRA
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1092 YARMOUTH E
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4550
Mailing Address - Country:US
Mailing Address - Phone:845-341-7665
Mailing Address - Fax:
Practice Address - Street 1:1092 YARMOUTH E
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4550
Practice Address - Country:US
Practice Address - Phone:845-341-7665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY919425163W00000X
FL9597087163W00000X
NY353237363LF0000X
FL11029978363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse