STEVENSON DOMINIQUE P.A. NPI 1912536301

NPI Information

NPI: 1912536301
Provider Name: STEVENSON DOMINIQUE, P.A.
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
1700 NJ-23 # 170
WAYNE, NJ
ZIP 07470
Phone: (732) 338-7202
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Stevenson Dominique, P.A. is a medical physician assistant in Wayne, NJ with 5 years of experience. Stevenson Dominique, P.A. NPI is 1912536301. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1700 NJ-23 # 170
WAYNE, NJ
ZIP 07470
Phone: (732) 338-7202

The NPI 1912536301 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/7/2020 and was last updated on 4/7/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		000512-P.A.	PUERTO RICO	No
2	363AM0700X	Physician Assistant	Medical	000512-P.A.	PUERTO RICO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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