Healthcare Provider Details

I. General information

NPI: 1497820385
Provider Name (Legal Business Name): STANLEY J SAVINESE JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 12/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 EVERGREEN DR
GLEN MILLS PA
19342-1059
US

IV. Provider business mailing address

2602 W 9TH ST
CHESTER PA
19013-2040
US

V. Phone/Fax

Practice location:
  • Phone: 610-579-3555
  • Fax: 610-579-3556
Mailing address:
  • Phone: 610-497-7454
  • Fax: 610-497-7487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberOS006543L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberOS006543L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: