Provider Demographics
NPI:1437525177
Name:MCCAFFREY, STACEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:
Last Name:MCCAFFREY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5489 WILES RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4220
Mailing Address - Country:US
Mailing Address - Phone:954-288-9393
Mailing Address - Fax:
Practice Address - Street 1:430 COMMODORE DR
Practice Address - Street 2:APT 212
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33325-2171
Practice Address - Country:US
Practice Address - Phone:734-645-9411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program