Healthcare Provider Details

I. General information

NPI: 1023790276
Provider Name (Legal Business Name): DARNELL STITH JR. APN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 ROUTE 73 N
MARLTON NJ
08053-4524
US

IV. Provider business mailing address

99 BEAUVOIR AVE
SUMMIT NJ
07901-3533
US

V. Phone/Fax

Practice location:
  • Phone: 856-988-3444
  • Fax: 856-988-0553
Mailing address:
  • Phone: 908-522-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ14883400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: