Basic Information
| Provider Information | |||||||||
| NPI: | 1497820385 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAVINESE | ||||||||
| FirstName: | STANLEY | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2602 W 9TH ST | ||||||||
| Address2: | |||||||||
| City: | CHESTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190132040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104977454 | ||||||||
| FaxNumber: | 6104977487 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 EVERGREEN DR | ||||||||
| Address2: | |||||||||
| City: | GLEN MILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193421059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105793555 | ||||||||
| FaxNumber: | 6105793556 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2006 | ||||||||
| LastUpdateDate: | 12/06/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QG0300X | OS006543L | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | 207QH0002X | OS006543L | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine |
ID Information
| ID | Type | State | Issuer | Description | 001609030 | 05 | PA | MEDICAID |