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General NPI Number Information
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NPI Number | 1306243241
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Entity Type | Individual
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Provider Name | STEPHANIE MARIE PISTILLI D.O
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Gender | Female
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Dates
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Enumeration Date | 11/20/2014
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Last Update Date | 02/25/2019
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Provider Practice Location Address
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Address Line | 3 COOPER PLAZA
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City | CAMDEN
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State | NJ
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Zip | 08103
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Country | US
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Telephone | 856-342-2965
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Fax | 856-365-1967
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Provider Business Mailing Address
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Address Line | 227 LAUREL RD STE 300
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City | VOORHEES
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State | NJ
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Zip | 08043-8303
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Country | US
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Telephone | 856-669-6050
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Fax | 856-651-0794
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MB09592500
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License Number State | NJ
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