Individual
MR. EDWARD THOMAS STISH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1711 E BROAD ST, HAZLETON, PA 18201-5691
(570) 453-5100
Mailing address
40 CONYNGHAM DRUMS RD, SUGARLOAF, PA 18249-3112
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP036414
PA
Other
Enumeration date
07/13/2026
Last updated
07/13/2026
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