Provider Demographics
NPI:1134300056
Name:CARNEY, STACY L (LMT)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:L
Last Name:CARNEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 OLD BOSTON POST ROAD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810
Mailing Address - Country:US
Mailing Address - Phone:800-723-2962
Mailing Address - Fax:800-957-5421
Practice Address - Street 1:131 OLD BOSTON POST ROAD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810
Practice Address - Country:US
Practice Address - Phone:800-723-2962
Practice Address - Fax:800-957-5421
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004130174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist