National Provider Identifier
Stacey L Dutka
Stacey L Dutka is listed in the NPPES registry with a primary specialty of Specialist in Tonawanda, NY and a listed phone number of (716) 833-4884.
Profile Overview
- NPI
- 1104187350
- Provider Type
- Individual
- Primary Specialty
- Specialist
- Enumeration Date
- June 05, 2012
- Last Updated
- June 05, 2012
Practice Location
- 2545 Sheridan Dr
- Tonawanda, NY 14150-9478
Phone: (716) 833-4884
Specialties
- Specialist (174400000X)
Full Record
- NPI
- 1104187350
- Entity Type
- Individual
- Last Name
- Dutka
- First Name
- Stacey
- Middle Name
- L
- Name Prefix
- Mrs.
- Mailing Street Address
- 2545 Sheridan Dr
- Mailing City
- Tonawanda
- Mailing State
- NY
- Mailing ZIP Code
- 14150-9478
- Mailing Country
- US
- Mailing Phone
- (716) 833-4884
- Practice Street Address
- 2545 Sheridan Dr
- Practice City
- Tonawanda
- Practice State
- NY
- Practice ZIP Code
- 14150-9478
- Practice Country
- US
- Practice Phone
- (716) 833-4884
- Enumeration Date
- June 05, 2012
- Last Updated
- June 05, 2012
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Specialist (174400000X)