Provider Demographics
NPI:1942841440
Name:SEARA, STEPHANIE B (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:B
Last Name:SEARA
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 PLEASANT PL
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-1830
Mailing Address - Country:US
Mailing Address - Phone:973-943-0663
Mailing Address - Fax:
Practice Address - Street 1:210 PASSAIC ST
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-1355
Practice Address - Country:US
Practice Address - Phone:201-438-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-05
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00544900363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant