Provider Demographics
NPI:1811568579
Name:GLORIA A STANCO, LICENSED PRACTICAL NURSE, P.C.
Entity Type:Organization
Organization Name:GLORIA A STANCO, LICENSED PRACTICAL NURSE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PRACTICAL NURSE
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STANCO
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:845-401-8896
Mailing Address - Street 1:45 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:WALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:12586-1213
Mailing Address - Country:US
Mailing Address - Phone:845-401-8896
Mailing Address - Fax:
Practice Address - Street 1:45 HIGH ST
Practice Address - Street 2:
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-1213
Practice Address - Country:US
Practice Address - Phone:845-401-8896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-05
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care