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Individual

DR. JESSE JOSEPH STAWICKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1235 WHITEHORSE MERCERVILLE RD, SUITE 316 BLDG. C, MERCERVILLE, NJ 08619-3810
(609) 581-5586
(609) 581-5779
Mailing address
9 HAMTON CT E, ROBBINSVILLE, NJ 08691-3640
(609) 581-5586
(609) 581-5779

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MB46599
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
047593100
AMERIHEALTH/KEYSTONE/PERS
NJ
01
0927766
CIGNA
NJ
01
110207564
MEDICARE RAILROAD
NJ
01
1K3956
PHS/HEALTHNET
NJ
01
2158854000
AMERIHEALTH 65
NJ
01
223709512
GREAT WEST
NJ
01
2261107
AETNA
NJ
01
4208912
TRADITIONAL AETNA
NJ
05
5404703
NJ
01
645148
AMERIHEALTH ADMIN.
NJ
01
987766
UNITED HEALTHCARE
NJ
01
MEP111
OXFORD
NJ
Enumeration date
12/29/2005
Last updated
10/13/2011
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