Provider Demographics
NPI:1306243241
Name:PISTILLI, STEPHANIE MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:MARIE
Last Name:PISTILLI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:227 LAUREL RD
Mailing Address - Street 2:STE 300
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-8303
Mailing Address - Country:US
Mailing Address - Phone:856-669-6050
Mailing Address - Fax:856-651-0794
Practice Address - Street 1:3 COOPER PLAZA
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103
Practice Address - Country:US
Practice Address - Phone:856-342-2965
Practice Address - Fax:856-365-1967
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB09592500207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology