Individual
STACEY KONTOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 PARK AVE S, 1103, NEW YORK, NY 10003-1503
(212) 674-0444
Mailing address
200 PARK AVE S, 1103, NEW YORK, NY 10003-1503
(212) 674-0444
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
265317
NY
Other
Enumeration date
04/12/2012
Last updated
07/16/2015
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