Provider Demographics
NPI:1417205311
Name:TURKEL, STACEY E (MS ED)
Entity Type:Individual
Prefix:MS
First Name:STACEY
Middle Name:E
Last Name:TURKEL
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 35TH ST
Mailing Address - Street 2:APT.2R
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-1302
Mailing Address - Country:US
Mailing Address - Phone:718-309-6709
Mailing Address - Fax:
Practice Address - Street 1:3626 35TH ST
Practice Address - Street 2:APT.2R
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-1302
Practice Address - Country:US
Practice Address - Phone:718-309-6709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor