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NPI Code Detail

MEDICARE: DR. RAND STACK MD

MEDICARE: DR. RAND STACK MD
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
12085R0202XDiagnostic Radiology Physician175062NY
22085R0202XDiagnostic Radiology Physician032665CT

General Provider Information

NPI Number : 1861498537
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAND STACK MD
Provider Business Mailing Address
First Line : 73 MARKET ST
Second Line :
City : YONKERS
State : NY
Zip : 10710-7616
Country : US
Telephone Number : 914-682-6430
Fax Number :
Provider Business Practice Location Address
First Line : 73 MARKET ST
Second Line :
City : YONKERS
State : NY
Zip : 10710-7616
Country : US
Telephone Number : 914-682-6430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 06/22/2016

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