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General NPI Number Information
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NPI Number | 1760658066
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Entity Type | Organization
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Legal Business Name | LUIS F STILLER MD PC
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 1 HAVEN PLAZA
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City | MANHATTAN
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State | NY
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Zip | 10009
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Country | US
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Telephone | 212-677-3973
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Fax |
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Provider Business Mailing Address
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Address Line | 1865 RANDALL AVENUE
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City | BRONX
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State | NY
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Zip | 10473-2932
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Country | US
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Telephone | 646-296-6926
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Fax | 718-378-1913
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MABEL ACEVEDO
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Credential |
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Telephone | 646-296-6926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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