Provider Demographics
NPI:1144872730
Name:MORALES RODRIGUEZ, STEFANY (DNP)
Entity type:Individual
Prefix:DR
First Name:STEFANY
Middle Name:
Last Name:MORALES RODRIGUEZ
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1092 DEWEY PL
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-2426
Mailing Address - Country:US
Mailing Address - Phone:908-397-6962
Mailing Address - Fax:
Practice Address - Street 1:817 RAHWAY AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-2212
Practice Address - Country:US
Practice Address - Phone:908-353-5750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00934400363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics