Individual
MR. MITCHELL CHARLES STASKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPA-C
Contact information
Practice address
PHILADELPIA VETERANS HOSPITAL, UNIVERSITY AND WOODLAND AVENUE, PHILADELPHIA, PA 19104
(215) 823-5800
Mailing address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 823-5800
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA-000830-L
PA
Other
Enumeration date
09/11/2006
Last updated
12/16/2013
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