MRS. Stacey L Dutka

NPI #1104187350 in Tonawanda, New York

Provider Information

NPI Number: 1104187350
Entity Type: Individual
Name: MRS. Stacey L Dutka
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Jun 5, 2012
Last Updated: Jun 5, 2012

Practice Location

Address: 2545 SHERIDAN DR
City: Tonawanda
State: New York
ZIP Code: 14150-9478
Phone: (716) 833-4884

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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