Active NPI
Stefan H. Faderl, M.D.
- Hematology & Oncology Physician
- Hackensack, NJ
National Provider Identifier
1689770844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 25MA09307400
- Practice address
- 92 Second St.
Hackensack, NJ 07601 - Phone
- (551) 996-3925
- Fax
- (551) 996-0574
- NPI assigned
- Sep 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Oncology Physician | 207RX0202X | K7015 | TX | |
| Hematology & Oncology Physician | 207RH0003X | 25MA09307400 | NJ | Primary |
Addresses
Primary practice location
92 Second St.
Hackensack, NJ 07601
Mailing address
100 First St.
Suite 301
Hackensack, NJ 07601
Phone (551) 996-3925
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 043181901 | Medicaid | TX | |
| 900002759 | Other | TX | RR MEDICARE |
| 84682X | Other | TX | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA09307400 | NJ | MD | Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384992000000",
"number": "1689770844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 FIRST ST.",
"address_2": "SUITE 301",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "07601",
"telephone_number": "551-996-3925",
"fax_number": "551-996-0574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "92 SECOND ST.",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "07601",
"telephone_number": "551-996-3925",
"fax_number": "551-996-0574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADERL",
"first_name": "STEFAN",
"middle_name": "H.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2013-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "TX",
"license": "K7015",
"primary": false
},
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "NJ",
"license": "25MA09307400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "043181901",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "900002759",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "84682X",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.