Krystina Maria Vafiadis
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Hackensack, NJ
NPI 1962341685 · NPPES record last updated Mar 27, 2026
Key facts
- NPI
- 1962341685
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 30 Prospect Ave
Hackensack, NJ 07601-1915 - Phone
- (551) 996-2000
- NPI assigned
- Mar 27, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
30 Prospect Ave
Hackensack, NJ 07601-1915
Mailing address
128 Summit St
Englewood, NJ 07631-4728
Phone (917) 868-5770
NPI Registry JSON
{
"created_epoch": "1774569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774569600000",
"number": "1962341685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 SUMMIT ST",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076314728",
"telephone_number": "917-868-5770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 PROSPECT AVE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076011915",
"telephone_number": "551-996-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAFIADIS",
"first_name": "KRYSTINA",
"middle_name": "MARIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-27",
"last_updated": "2026-03-27",
"certification_date": "2026-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.