Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | 65006253 | NY |
N | 2081S0010X | Sports Medicine | 65006253 | NY |
N | 213ES0000X | Sports Medicine | 65006253 | NY |
Y | 213ES0103X | Foot & Ankle Surgery | 65006253 | NY |
NPI | 1356518633 |
---|---|
Provider Name | Dr. Stacey K Baptiste |
First Address | Huntington, NY 11743-2988 |
Second Address | Huntington, NY 11743-2988 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2008 |
Last Update Date | 11/09/2014 |