Individual
STEPHANIE LORETTA BASELICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(212) 639-2000
Mailing address
22 GALLANT FOX DR, MEDIA, PA 19063-5253
(215) 407-7966
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
723493
NY
Other
Enumeration date
02/04/2019
Last updated
02/04/2019
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