Provider Demographics
NPI:1104554070
Name:PAPO, STACEY (CEP)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:
Last Name:PAPO
Suffix:
Gender:F
Credentials:CEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 JACOB ST
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-1615
Mailing Address - Country:US
Mailing Address - Phone:845-902-8394
Mailing Address - Fax:
Practice Address - Street 1:385 JACOB ST
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-1615
Practice Address - Country:US
Practice Address - Phone:845-902-8394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist