MEDICARE: TREVOR STONE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	MA067524	PA

General Provider Information

NPI Number	:	1720891039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TREVOR STONE

Provider Business Mailing Address
First Line	:	1020 SANSOM ST STE 239
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5002
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 SANSOM ST STE 239
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-5002
Country	:	US
Telephone Number	:	215-955-6844
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2025
Last Update Date	:	03/23/2026

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Directions to “ TREVOR STONE ” Practice Location

Language	Start Address	Practice Location

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