Provider Demographics
NPI:1811170012
Name:STONICH, PATRICK ROBERT (RN,BSN)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:ROBERT
Last Name:STONICH
Suffix:
Gender:M
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SCHNECKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18078-2175
Mailing Address - Country:US
Mailing Address - Phone:610-820-8301
Mailing Address - Fax:267-319-1531
Practice Address - Street 1:4315 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SCHNECKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18078-2175
Practice Address - Country:US
Practice Address - Phone:610-820-8301
Practice Address - Fax:267-319-1531
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN564750163WH0200X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018007450001Medicaid
PA398053Medicare Oscar/Certification