Provider Demographics
NPI:1659365732
Name:STYLE FAMILY MEDICINE ASSOC PA
Entity Type:Organization
Organization Name:STYLE FAMILY MEDICINE ASSOC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:D
Authorized Official - Last Name:STYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-772-1880
Mailing Address - Street 1:1 BRITTON PLACE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2514
Mailing Address - Country:US
Mailing Address - Phone:856-772-1880
Mailing Address - Fax:856-770-0718
Practice Address - Street 1:1 BRITTON PLACE
Practice Address - Street 2:SUITE 12
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-2514
Practice Address - Country:US
Practice Address - Phone:856-772-1880
Practice Address - Fax:856-770-0718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2949008Medicaid
058265Medicare ID - Type Unspecified