Individual
KAYLA MARIE STANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
270 E MAIN ST, BAY SHORE, NY 11706-8420
(631) 591-7470
Mailing address
19 MACON AVE, SAYVILLE, NY 11782-2409
(631) 278-3690
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
663471
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
308831
NY
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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