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Individual

ANGELINA STUPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1142 COUNTY ROUTE 3, HANNIBAL, NY 13074-2352
(315) 806-7061
Mailing address
1142 COUNTY ROUTE 3, HANNIBAL, NY 13074-2352
(315) 806-7061

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
319628
NY

Other

Enumeration date
11/12/2014
Last updated
11/12/2014
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