Individual
DR. MARIA N.C. STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
680 S MAIN ST, STE. 205, CHESHIRE, CT 06410-3181
(203) 699-9898
(203) 250-7878
Mailing address
680 S MAIN ST, STE. 205, CHESHIRE, CT 06410-3181
(203) 699-9898
(203) 250-7878
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
028514
CT
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
028514
CT
Other
Enumeration date
07/11/2005
Last updated
12/07/2016
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