Healthcare Provider Details

I. General information

NPI: 1346845872
Provider Name (Legal Business Name): JOAN STILLING MD, MSC, FRCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2020
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST # F-1600
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

525 E 68TH ST # F-1600
NEW YORK NY
10065-4870
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-1500
  • Fax: 212-746-8303
Mailing address:
  • Phone: 212-746-1500
  • Fax: 212-746-8303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberD0090777
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number314736-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: