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General NPI Number Information
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NPI Number | 1215226501
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Entity Type | Individual
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Provider Name | STACY PLAYER
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Gender | Female
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Dates
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Enumeration Date | 04/07/2011
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Last Update Date | 04/07/2011
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Provider Practice Location Address
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Address Line | 462 W OLIVE ST
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City | LONG BEACH
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State | NY
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Zip | 11561-3128
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Country | US
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Telephone | 516-567-4631
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Fax |
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Provider Business Mailing Address
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Address Line | 7164 168TH ST
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City | FLUSHING
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State | NY
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Zip | 11365-3242
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Country | US
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Telephone | 718-591-8100
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Fax | 718-969-2941
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 079567-1
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License Number State | NY
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