Provider Demographics
NPI:1033542527
Name:STASIUK, CHRISTINA (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:STASIUK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:753 N 26TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1601 CHESTNUT ST
Practice Address - Street 2:2 LIBERTY PLACE TL08F
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19192-0003
Practice Address - Country:US
Practice Address - Phone:215-761-7168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006477E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine