Healthcare Provider Details

I. General information

NPI: 1144321472
Provider Name (Legal Business Name): ROSARIO FATIMA M HOHL-STILLWELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 05/14/2021
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 PENNINGTON RD
TRENTON NJ
08618-2655
US

IV. Provider business mailing address

1423 PENNINGTON RD
TRENTON NJ
08618-2655
US

V. Phone/Fax

Practice location:
  • Phone: 609-882-8080
  • Fax: 609-882-8433
Mailing address:
  • Phone: 609-882-8080
  • Fax: 609-882-8433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA05809900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: