| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JONATHAN ALLAN STEFELY | 1265992192 | 2022-10-01 |
Jonathan Allan Stefely is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1265992192. Registration indicates Jonathan Allan Stefely is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) (Allopathic & Osteopathic Physicians, Pathology) (Pathology: Blood Banking & Transfusion Medicine, ) (All Other Specialties & Provider Types, ) (Pathology Blood Banking & Transfusion Medicine, Allopathic & Osteopathic Physicians) (Pathology, )
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Dr. Jonathan Allan Stefely MD, PHD |
| Practice Office Address | 55 FRUIT ST BOSTON, MA US |
| Practice Office Telephone | 6177262000 |
| Practice Office Fax | 6177243947 |
| Mailing Address | 27 LITTLE POND RD BELMONT, MA 024784614 US |
| Business Telephone | 6517175099 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 207ZB0001X PRIMARY | Allopathic & Osteopathic Physicians Pathology Pathology: Blood Banking & Transfusion Medicine All Other Specialties & Provider Types Pathology Blood Banking & Transfusion Medicine Allopathic & Osteopathic Physicians Pathology | 292153
MA |