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General NPI Number Information
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NPI Number | 1326086091
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Entity Type | Organization
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Legal Business Name | PARKSIDE MEDICAL ASSOCIATES, P.A.
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1450 PARKSIDE AVE SUITE 21
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City | TRENTON
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State | NJ
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Zip | 08638-2946
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Country | US
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Telephone | 609-883-9800
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Fax | 609-883-4350
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Provider Business Mailing Address
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Address Line | 1450 PARKSIDE AVE SUITE 21
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City | TRENTON
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State | NJ
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Zip | 08638-2946
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Country | US
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Telephone | 609-883-9800
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Fax | 609-883-4350
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Authorized Official
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Title or Position | FOUNDER/PRESIDENT
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Name | DR. WILLIAM DAVID STANLEY
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Credential | M.D.
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Telephone | 609-883-9800
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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 |
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License Number State |
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