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General NPI Number Information
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NPI Number | 1710038740
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Entity Type | Organization
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Legal Business Name | PASCACK HOSPITAL PHYSICIANS SERVICES, P.A.
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 250 OLD HOOK RD
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City | WESTWOOD
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State | NJ
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Zip | 07675-3123
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Country | US
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Telephone | 201-358-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 66 W GILBERT ST 2ND FLOOR
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City | TINTON FALLS
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State | NJ
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Zip | 07701-4947
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Country | US
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Telephone | 732-212-0051
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Fax | 732-212-0713
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHILLIP LA STELLA
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Credential | MD
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Telephone | 201-358-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State | NJ
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