| Doctor Name: | SUE E. STALEY |
| NPI Number: | 1003918400 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | F302271 |
| Business Practice Address: | 350 Parrish St Canandaigua, NY - 144241731 |
| Business Phone Number: | 5853966071 |
| Business Fax Number: | |
| Mailing Address: | 410 Ryan Way, AVON |
| State: | NY |
| Postal Code: | 144141462 |
| Phone Number: | 5854384048 |
| Fax Number: | |
| NPI Enumeration Date: | 09/05/2006 |
| NPI Last Update Date: | 12/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | F302271 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |