Provider Demographics
NPI:1659949568
Name:STACHOWSKI, MARGARET (ANP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:STACHOWSKI
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 S BLACK HORSE PIKE # 322
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2703
Mailing Address - Country:US
Mailing Address - Phone:856-952-2850
Mailing Address - Fax:
Practice Address - Street 1:1134 S BLACK HORSE PIKE # 322
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-2703
Practice Address - Country:US
Practice Address - Phone:856-345-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01111800363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology