Individual
WERNER R STICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
17 BANK AVE, SMITHTOWN, NY 11787-2703
(631) 601-4020
Mailing address
69 W 3RD ST, RONKONKOMA, NY 11779-3952
(631) 601-4020
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
754979-1
NY
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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