Individual
MR. DANIEL STAKUTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 RIVERS EDGE DR UNIT 448, MEDFORD, MA 02155-5477
(508) 380-2208
Mailing address
100 RIVERS EDGE DR UNIT 448, MEDFORD, MA 02155-5477
(508) 380-2208
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2312263
MA
Other
Enumeration date
04/09/2025
Last updated
04/09/2025
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