Provider Demographics
NPI:1801570486
Name:PISCITELL, STACEY (RN)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:
Last Name:PISCITELL
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 1:6280 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-7700
Mailing Address - Country:US
Mailing Address - Phone:315-445-8258
Mailing Address - Fax:315-445-8421
Practice Address - Street 1:6280 RANDALL RD
Practice Address - Street 2:
Practice Address - City:JAMESVILLE
Practice Address - State:NY
Practice Address - Zip Code:13078-7700
Practice Address - Country:US
Practice Address - Phone:315-445-8258
Practice Address - Fax:315-445-8421
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY555064-01163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool