Provider Demographics
NPI:1043224025
Name:STILLMAN, JOSHUA ISSACHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:ISSACHAR
Last Name:STILLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 ROUTE 59 STE 103A
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4927
Mailing Address - Country:US
Mailing Address - Phone:845-368-4800
Mailing Address - Fax:845-369-1697
Practice Address - Street 1:128 ASHFORD AVE
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1924
Practice Address - Country:US
Practice Address - Phone:845-368-4800
Practice Address - Fax:845-369-1697
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY173873207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01367335Medicaid
NY01367335Medicaid
NY090F331Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE