Individual provider · Type 1 NPI
Stacy Sanicola, NURSE PRACTITIONER
Family Nurse Practitioner · Staten Island, NY
NPI number
1790200459
Active
Practice location
477 Philip Ave
Staten Island, NY 10312-5818
Mailing address
73 Gervil St
Staten Island, NY 10309-4230
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 342171 (NY) |
Family Nurse Practitioner: Definition to come...
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About NPI 1790200459
Stacy Sanicola, NURSE PRACTITIONER's National Provider Identifier is 1790200459, issued on Aug 3, 2017. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Staten Island, NY. The record was last updated on Apr 11, 2023.