Individual
STACEY VICIERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1524 E 45TH ST, BROOKLYN, NY 11234-3004
(347) 760-4030
Mailing address
1524 E 45TH ST, BROOKLYN, NY 11234-3004
(347) 760-4030
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
F359656
NY
Other
Enumeration date
05/20/2026
Last updated
05/20/2026
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