Milliman, Stacy L

Milliman, Stacy L is an individual health care provider with primary practice located at 2050 Tilden Ave Box 1000, New Hartford NY 13413-3613. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Milliman, Stacy L can be contacted via phone (315) 797-3114.

Contact Information

Primary practice address
2050 Tilden Ave Box 1000 New Hartford NY 13413-3613
Phone: (315) 797-3114
Fax: (315) 624-0474
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X 020093-1 New York

Profile Details

NPI number 1538430806
LBN Legal business name Milliman, Stacy L
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2012
Last updated Jan 19th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538430806 NPPES
New York MEDICAID 00313539
New York MEDICAID 01815443

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