Individual
MS. STACY ANNE CRILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 HORIZON DR., HUNTINGTON, NY 11743
(631) 920-8088
(631) 920-8166
Mailing address
55 HORIZON DR., HUNTINGTON, NY 11743
(631) 920-8088
(631) 920-8166
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
22618671
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
401750
NY
Other
Enumeration date
07/24/2006
Last updated
07/28/2014
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