Provider Demographics
NPI:1730523556
Name:KARGMAN-KAYE, STACEY JOI (NMD, LAC)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:JOI
Last Name:KARGMAN-KAYE
Suffix:
Gender:F
Credentials:NMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10806 REISTERSTOWN RD STE 1E
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4620
Mailing Address - Country:US
Mailing Address - Phone:410-356-4600
Mailing Address - Fax:410-654-8995
Practice Address - Street 1:10806 REISTERSTOWN RD STE 1E
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4620
Practice Address - Country:US
Practice Address - Phone:410-356-4600
Practice Address - Fax:410-654-8995
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00971171100000X
VT099.0000168175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist