Provider Demographics
NPI:1144321472
Name:HOHL-STILLWELL, ROSARIO FATIMA M (MD)
Entity type:Individual
Prefix:
First Name:ROSARIO FATIMA
Middle Name:M
Last Name:HOHL-STILLWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 PENNINGTON RD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-2655
Mailing Address - Country:US
Mailing Address - Phone:609-882-8080
Mailing Address - Fax:609-882-8433
Practice Address - Street 1:1423 PENNINGTON RD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-2655
Practice Address - Country:US
Practice Address - Phone:609-882-8080
Practice Address - Fax:609-882-8433
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05809900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5321603Medicaid
NJ139790ZFYBMedicare PIN
NJHO139790Medicare ID - Type Unspecified
NJ5321603Medicaid