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Individual
STACI NASO
Active
Individual
STACI NASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
26705
SC
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
26705
SC
363LP0200X
Pediatric Nurse Practitioner
382562
NY
Other
Enumeration date
08/07/2015
Last updated
07/22/2025
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