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Individual
MRS. STACY LYNN ENTIN
Active
Individual
MRS. STACY LYNN ENTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASST.
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
009989-01
NY
363A00000X
Physician Assistant
Primary
009989-1
NY
Other
Enumeration date
12/04/2006
Last updated
10/16/2015
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