Individual
JENNIFER J STALICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1561 LONG POND ROAD, SUITE 408, ROCHESTER, NY 14626-4135
(585) 723-7575
(585) 368-4890
Mailing address
1561 LONG POND ROAD, SUITE 408, ROCHESTER, NY 14626-4135
(585) 723-7575
(585) 368-4890
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
248623
NY
207RP1001X
Pulmonary Disease Physician
Primary
248623
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02969331
—
NY
Enumeration date
08/29/2006
Last updated
05/16/2019
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