Stacey Crivelli

NPI #1740772029 in Kings Park, New York

Provider Information

NPI Number: 1740772029
Entity Type: Individual
Name: Stacey Crivelli
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Early Intervention Provider Agency
Enumeration Date: Jun 3, 2018
Last Updated: Jun 3, 2018

Practice Location

Address: 87 INDIAN HEAD RD
City: Kings Park
State: New York
ZIP Code: 11754-4401
Phone: (631) 387-2627

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X
Early Intervention Provider Agency	252Y00000X	Primary

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