Provider Demographics
NPI:1063556405
Name:ANNE MARIE STILWELL, M.D., P.C.
Entity type:Organization
Organization Name:ANNE MARIE STILWELL, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:STILWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-448-6373
Mailing Address - Street 1:PO BOX 140057
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-0057
Mailing Address - Country:US
Mailing Address - Phone:718-448-6373
Mailing Address - Fax:718-448-6648
Practice Address - Street 1:45 MCCLEAN AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-4634
Practice Address - Country:US
Practice Address - Phone:718-448-6373
Practice Address - Fax:718-448-6648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186024207L00000X, 208VP0014X, 207LP2900X
NY241180208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY169990OtherELDERPLAN
NY186024OtherHIP
NY65J532OtherEMPIRE BC BS
NY4C1349OtherPHS
NY5301821OtherGHI
NY050052299OtherRAILROAD MEDICARE
NYP428465OtherOXFORD
NY60303515OtherFIDELIS
NY5301821OtherGHI
NY=========OtherUNITED HEALTHCARE
NY=========OtherMAGNACARE
NY169990OtherELDERPLAN
NY186024OtherHIP
NY4C1349OtherPHS
NY=========OtherMAGNACARE
NY65J532Medicare ID - Type UnspecifiedMEDICARE