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General NPI Number Information
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NPI Number | 1033542527
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Entity Type | Individual
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Provider Name | CHRISTINA STASIUK D.O.
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Gender | Female
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Dates
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Enumeration Date | 08/20/2013
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 1601 CHESTNUT ST 2 LIBERTY PLACE TL08F
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City | PHILADELPHIA
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State | PA
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Zip | 19192-0003
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Country | US
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Telephone | 215-761-7168
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Fax |
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Provider Business Mailing Address
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Address Line | 753 N 26TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19130-2429
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS006477E
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License Number State | PA
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