Stivala, Charles M.

Stivala, Charles M. is an individual health care provider with primary practice located at 65 W Jimmie Leeds Rd , Pomona NJ 08240-9102. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Stivala, Charles M. can be contacted via phone (609) 748-7089.

Contact Information

Primary practice address
65 W Jimmie Leeds Rd Pomona NJ 08240-9102
Phone: (609) 748-7089
Fax: (609) 652-3460
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X OS012844 Pennsylvania
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 25MB10453400 New Jersey

Profile Details

NPI number 1295721447
LBN Legal business name Stivala, Charles M.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Dec 19th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295721447 NPPES
New Jersey MEDICAID 0666726
New Jersey MEDICAID 100816858

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