Provider Demographics
NPI:1720327430
Name:VELARDI, STACI (RN)
Entity Type:Individual
Prefix:MS
First Name:STACI
Middle Name:
Last Name:VELARDI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-7810
Mailing Address - Country:US
Mailing Address - Phone:914-589-8238
Mailing Address - Fax:
Practice Address - Street 1:311 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-7810
Practice Address - Country:US
Practice Address - Phone:914-589-8238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY529755-1163W00000X
NJ26NR10915300163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse