Provider Demographics
NPI:1356518633
Name:BAPTISTE, STACEY K (DPM)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:K
Last Name:BAPTISTE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:158 E MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2988
Mailing Address - Country:US
Mailing Address - Phone:631-271-2491
Mailing Address - Fax:631-271-2608
Practice Address - Street 1:158 E MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2988
Practice Address - Country:US
Practice Address - Phone:631-271-2491
Practice Address - Fax:631-271-2608
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY65006253213ES0103X, 213EP1101X, 213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine