Provider Demographics
NPI:1831184811
Name:NOSHENY, STANLEY Z (MD)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:Z
Last Name:NOSHENY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8021A CASTOR AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-2733
Mailing Address - Country:US
Mailing Address - Phone:215-745-5605
Mailing Address - Fax:
Practice Address - Street 1:8021A CASTOR AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-2733
Practice Address - Country:US
Practice Address - Phone:215-745-5605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2009-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD009570E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA111630869OtherTRAVELERS MEDICARE
PA111630869OtherTRAVELERS MEDICARE
PA006470Medicare PIN