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General NPI Number Information
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NPI Number | 1700156080
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Entity Type | Individual
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Provider Name | MRS. JUDY STOFFEL
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Gender | Female
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | 8442 S MAIN ST
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City | EVANS MILLS
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State | NY
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Zip | 13637-3201
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Country | US
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Telephone | 315-629-4331
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Fax |
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Provider Business Mailing Address
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Address Line | 35 MADISON AVENUE P.O. BOX 673
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City | ANTWERP
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State | NY
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Zip | 13608
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Country | US
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Telephone | 315-659-8401
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Fax |
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 305177-1
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License Number State | NY
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