Provider Demographics
NPI:1588817688
Name:STANFIELD, KRISTY LEIGH (PA)
Entity Type:Individual
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First Name:KRISTY
Middle Name:LEIGH
Last Name:STANFIELD
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Gender:F
Credentials:PA
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Mailing Address - Street 1:STONY BROOK UNIVERSITY MEDICAL CTR
Mailing Address - Street 2:DEPT OF SURGERY, HSC T19-090
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:631-444-1435
Mailing Address - Fax:631-444-8824
Practice Address - Street 1:STONY BROOK UNIVERSITY MEDICAL CTR
Practice Address - Street 2:DEPT OF SURGERY, HSC T19-090
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:631-444-1435
Practice Address - Fax:631-444-8824
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2010-09-29
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Provider Licenses
StateLicense IDTaxonomies
NY012969-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant