Individual
THOMAS STAVOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
45 RESEARCH WAY, SUITE 008 & 108, EAST SETAUKET, NY 11733-6401
(631) 941-2704
(631) 941-2009
Mailing address
45 RESEARCH WAY, SUITE 204, EAST SETAUKET, NY 11733-6401
(631) 941-2704
(631) 350-7200
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
178562-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
O1416908
—
NY
Enumeration date
08/29/2006
Last updated
09/19/2013
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