Healthcare Provider Details

I. General information

NPI: 1336802529
Provider Name (Legal Business Name): CARMELA STULGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2021
Last Update Date: 10/15/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 23RD ST # 164
SHARPSBURG PA
15215-2825
US

IV. Provider business mailing address

600 E 17TH AVE
MUNHALL PA
15120-2030
US

V. Phone/Fax

Practice location:
  • Phone: 724-545-1600
  • Fax:
Mailing address:
  • Phone: 412-726-2928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number722025
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: