National Provider Identifier

Stacy Lyn Bishoff

Stacy Lyn Bishoff is listed in the NPPES registry with a primary specialty of Community Health Worker in Freedom, NY and a listed phone number of (716) 492-0492.

NPI 1205171212Freedom, NYCommunity Health Worker

Profile Overview

NPI
1205171212
Provider Type
Individual
Primary Specialty
Community Health Worker
Enumeration Date
December 02, 2012
Last Updated
December 02, 2012

Practice Location

  • 11622 Scotch RD
  • Freedom, NY 14065-9770

Phone: (716) 492-0492

Specialties

  • Community Health Worker (172V00000X)
Full Record
NPI
1205171212
Entity Type
Individual
Last Name
Bishoff
First Name
Stacy
Middle Name
Lyn
Mailing Street Address
11622 Scotch RD
Mailing City
Freedom
Mailing State
NY
Mailing ZIP Code
14065-9770
Mailing Country
US
Mailing Phone
(716) 492-0492
Practice Street Address
11622 Scotch RD
Practice City
Freedom
Practice State
NY
Practice ZIP Code
14065-9770
Practice Country
US
Practice Phone
(716) 492-0492
Enumeration Date
December 02, 2012
Last Updated
December 02, 2012
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Community Health Worker (172V00000X)