Provider Demographics
NPI:1467860528
Name:STABINSKI, MICHAEL ERIC (CRNA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ERIC
Last Name:STABINSKI
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 BRADY RD
Mailing Address - Street 2:
Mailing Address - City:SACKETS HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:13685-9504
Mailing Address - Country:US
Mailing Address - Phone:305-527-8594
Mailing Address - Fax:
Practice Address - Street 1:826 WASHINGTON ST FL 3
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-4063
Practice Address - Country:US
Practice Address - Phone:315-785-8509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22 685238367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered