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1619657137
STACEY MOUSAW CARPENTER
SYRACUSE, NY
NPI
1619657137
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NY 404991)
Enumeration Date
2023-07-19
Last Update Date
2023-07-19
Business Address
STACEY MOUSAW CARPENTER PMHNP
301 PROSPECT AVE
SYRACUSE, NY 13203-1899
Phone number: 315-726-8600
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Mailing Address
STACEY MOUSAW CARPENTER PMHNP
5465 ORANGEPORT RD UNIT 503
BREWERTON, NY 13029-1804
Phone number: 252-675-8887
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