Individual
STACEY A MUSCOLINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.N.P.
Contact information
Practice address
151 INTREPID LN, SYRACUSE, NY 13205-2552
(315) 469-8191
(315) 469-4482
Mailing address
6420 KILLOE RD, BALDWINSVILLE, NY 13027-9094
(315) 635-0008
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
F381140-1
NY
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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