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NPI Code Detail

MEDICARE: DR. JONATHAN JAMES STOLL MD

MEDICARE: DR. JONATHAN JAMES STOLL MD
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
1207RP1001XPulmonary Disease Physician25MA11052200NJ
2207RC0200XCritical Care Medicine (Internal Medicine) Physician25MA11052200NJ

General Provider Information

NPI Number : 1881121218
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN JAMES STOLL MD
Provider Business Mailing Address
First Line : 200 TRENTON RD
Second Line :
City : BROWNS MILLS
State : NJ
Zip : 08015-1764
Country : US
Telephone Number : 609-893-1200
Fax Number :
Provider Business Practice Location Address
First Line : 200 TRENTON RD
Second Line :
City : BROWNS MILLS
State : NJ
Zip : 08015-1764
Country : US
Telephone Number : 609-893-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2017
Last Update Date : 07/19/2023

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