Provider Demographics
NPI:1386061372
Name:GUILIANA, STEPHEN MICHAEL (DPM)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MICHAEL
Last Name:GUILIANA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 TOWNE CTR STE 405
Mailing Address - Street 2:
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1362
Mailing Address - Country:US
Mailing Address - Phone:973-927-2525
Mailing Address - Fax:973-927-3249
Practice Address - Street 1:66 TOWNE CTR STE 405
Practice Address - Street 2:
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1362
Practice Address - Country:US
Practice Address - Phone:973-927-2525
Practice Address - Fax:973-927-3249
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00328000213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery