Provider Demographics
NPI:1649705971
Name:PILLAI, STEPHANIE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:PILLAI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 OAK KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6315
Mailing Address - Country:US
Mailing Address - Phone:240-476-4337
Mailing Address - Fax:
Practice Address - Street 1:2001 PROVIDENCE AVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-5504
Practice Address - Country:US
Practice Address - Phone:610-502-8154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA004279363A00000X
PAMA059067363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant