Individual
STACEY ARLENE FUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
270 PARK AVE, HUNTINGTON, NY 11743
(516) 719-5765
Mailing address
270 PARK AVE, HUNTINGTON, NY 11743-2787
(516) 719-5765
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
186314
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01693549
—
NY
Enumeration date
03/09/2006
Last updated
02/28/2019
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