Provider Demographics
NPI:1548026420
Name:REHEMAFNP MEDICAL ASSOCIATES, LLC
Entity type:Organization
Organization Name:REHEMAFNP MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WANGAI
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:201-780-2806
Mailing Address - Street 1:393 STEGMAN PKWY # 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-1412
Mailing Address - Country:US
Mailing Address - Phone:201-780-2806
Mailing Address - Fax:
Practice Address - Street 1:1815 JFK BLVD STE B
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-2180
Practice Address - Country:US
Practice Address - Phone:201-780-2806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty