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Individual
MARYLOU STANTON
Active
Individual
MARYLOU STANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
339648
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15-0532180
TAX IDENTIFICATION NUMBER
NY
Enumeration date
06/12/2015
Last updated
01/24/2018
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