Provider Demographics
NPI:1215177654
Name:SZUMSKI, STANLEY (PA-C)
Entity type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:
Last Name:SZUMSKI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 GLASSBORO RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08097-1018
Mailing Address - Country:US
Mailing Address - Phone:856-853-0848
Mailing Address - Fax:856-853-1889
Practice Address - Street 1:307 GLASSBORO RD
Practice Address - Street 2:
Practice Address - City:WOODBURY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08097-1018
Practice Address - Country:US
Practice Address - Phone:856-853-0848
Practice Address - Fax:856-853-1889
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00209100363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical