Individual
STACEY GARGUILO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 BOSTON MEDICAL CTR PL, BOSTON, MA 02118-2908
(617) 638-6950
(617) 638-6966
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2281412
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110123670A
—
MA
05
—
3123926
—
NH
Enumeration date
12/04/2012
Last updated
04/21/2026
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