Doctor Name: | MALGORZATA STASIAK CARIC |
NPI Number: | 1417254970 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | F3024041 |
Business Practice Address: | 1220 Pine Tree Rd Cutchogue, NY - 119351555 |
Business Phone Number: | 6317272827 |
Business Fax Number: | |
Mailing Address: | 1220 Pine Tree Rd, CUTCHOGUE |
State: | NY |
Postal Code: | 119351555 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/18/2011 |
NPI Last Update Date: | 02/18/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F3024041 |
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: |