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NPI Code Detail

MEDICARE: DARLENE C STIFFLER LCSW

MEDICARE: DARLENE C STIFFLER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker070141NY

General Provider Information

NPI Number : 1124107859
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARLENE C STIFFLER LCSW
Provider Business Mailing Address
First Line : 2249 ALEXANDER RD
Second Line :
City : GALWAY
State : NY
Zip : 12074-2401
Country : US
Telephone Number : 518-882-1691
Fax Number :
Provider Business Practice Location Address
First Line : 419 GEYSER RD
Second Line :
City : BALLSTON SPA
State : NY
Zip : 12020-3022
Country : US
Telephone Number : 518-587-8810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2006
Last Update Date : 07/08/2007

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Directions to “ DARLENE C STIFFLER LCSW” Practice Location

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