Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 38MC00134300 | NJ |
NPI | 1124028139 |
---|---|
Provider Name | Dr. Richard A. Stiso |
First Address | Florham Park, NJ 07932-2004 |
Second Address | Florham Park, NJ 07932-2004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2005 |
Last Update Date | 22/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0103700000 | AMERIHEALTH (01) | NJ |
0885115 | CIGNA (01) | NJ |
5333300 | (05) | NJ |
561794 | AETNA (01) | NJ |
593175 | UNITEDHEALTHCARE (01) | NJ |
MC01343 | LANDMARK (01) | NJ |
P421418 | OXFORD (01) | NJ |
T77864 | (02) | NJ |
X40481 | WELL CHOICE (01) | NJ |