Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | C1-0011425 | DE |
N | 207VX0201X | Gynecologic Oncologist | MD448383 | PA |
NPI | 1548468259 |
---|---|
Provider Name | Stephanie Jean |
First Address | Newark, DE 19713-2049 |
Second Address | Newark, DE 19713-2055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2007 |
Last Update Date | 08/10/2015 |