Provider Demographics
NPI:1790965259
Name:IRENA O. STOLAR, M.D., P.A.
Entity Type:Organization
Organization Name:IRENA O. STOLAR, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRENA
Authorized Official - Middle Name:OLGA
Authorized Official - Last Name:STOLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-453-0500
Mailing Address - Street 1:320 CHRISTIANA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1653
Mailing Address - Country:US
Mailing Address - Phone:302-453-0500
Mailing Address - Fax:302-454-1906
Practice Address - Street 1:320 CHRISTIANA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1653
Practice Address - Country:US
Practice Address - Phone:302-453-0500
Practice Address - Fax:302-454-1906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0001994207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1790965259Medicaid
DEB66463Medicare UPIN
DEG02758Medicare PIN