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Individual

MRS. MARIE D STAHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP NURSEPRACTITIONER

Contact information

Practice address
6251 STATE ROUTE 31, CICERO, NY 13039
(315) 699-9595
(315) 699-7095
Mailing address
6251 STATE ROUTE 31, CICERO, NY 13039
(315) 699-9595
(315) 699-7095

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR12297500
NJ
363LP0200X
Pediatric Nurse Practitioner
Primary
26NJ00105800
NJ

Other

Enumeration date
09/14/2007
Last updated
03/27/2012
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