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Contact Information

STACEY DIGIACOMO, PA
4 ROOSEVELT AVE
PORT JEFFERSON STATION, NY11776-3363
 Phone: 631-331-0500
 Fax: 631-331-1644
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for STACEY DIGIACOMO · (Female)

NPI # 1023233103
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 04/16/2007
Last updated 12/03/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 007238
Hospital affiliation(s)
  • BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER - (Acute Care)
    101 HOSPITAL ROAD
    PATCHOGUE, NY 11772
  • JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON - (Acute Care)
    75 NORTH COUNTRY ROAD
    PORT JEFFERSON, NY 11777
  • ST CHARLES HOSPITAL - (Acute Care)
    200 BELLE TERRE ROAD
    PORT JEFFERSON, NY 11777
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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