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General NPI Number Information
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NPI Number | 1598446528
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Entity Type | Individual
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Provider Name | REBECCA STANZIALE PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1 NAMI LN STE 8
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City | TRENTON
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State | NJ
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Zip | 08619-1251
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Country | US
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Telephone | 609-631-9006
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Fax |
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Provider Business Mailing Address
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Address Line | 33 LONGVIEW DR
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City | HOLMDEL
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State | NJ
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Zip | 07733-1680
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Country | US
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Telephone | 732-796-4856
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MP00790000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 25MP00790000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00790000
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License Number State | NJ
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