Individual
RAYMOND EDWARD STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6564
(315) 298-3968
Mailing address
61 DELANO ST, PULASKI, NY 13142-1400
(315) 298-6564
(315) 298-3968
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
631447-1
NY
Other
Enumeration date
10/08/2010
Last updated
10/08/2010
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