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NPI Code Detail

MEDICARE: STACEY MARSHALL D.C., P.C.

MEDICARE: STACEY MARSHALL D.C., P.C.
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
1111N00000XChiropractorX008337NY

General Provider Information

NPI Number : 1972671741
Entity Type Code : Organization
Provider Name (Legal Business Name) : STACEY MARSHALL D.C., P.C.
Provider Business Mailing Address
First Line : 72 W MAIN ST
Second Line :
City : OYSTER BAY
State : NY
Zip : 11771-2211
Country : US
Telephone Number : 516-922-4606
Fax Number : 516-922-4399
Provider Business Practice Location Address
First Line : 72 W MAIN ST
Second Line :
City : OYSTER BAY
State : NY
Zip : 11771-2211
Country : US
Telephone Number : 516-922-4606
Fax Number : 516-922-4399
Authorized Official
Title or Position : OWNER
Name : DR. STACEY LYNN MARSHALL
Credential : D.C.
Telephone Number : 516-922-4606
Provider Enumeration Date : 12/01/2006
Last Update Date : 01/13/2010

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