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Individual

STACY A MAROTTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
4 COULTER RD, CLIFTON SPRINGS, NY 14432
(315) 462-3571
(315) 462-7478
Mailing address
601 ELMWOOD AVE, BOX 679B, ROCHESTER, NY 14642-0001
(315) 462-3571
(315) 462-7478

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
304193
NY
363L00000X
Nurse Practitioner
Primary
F304193
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02978590
NY
Enumeration date
08/17/2006
Last updated
07/06/2023
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