Individual
STACEY A PENDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP-BC
Contact information
Practice address
10 - 42 MITCHELL AVENUE, BINGHAMTON, NY 13903
(607) 762-2468
(607) 762-3871
Mailing address
346 GRAND AVE, JOHNSON CITY, NY 13790-2580
(607) 762-2468
(607) 762-3871
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F381553
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03018146
—
NY
Enumeration date
01/25/2007
Last updated
11/06/2014
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