Healthcare Provider Details

I. General information

NPI: 1578487443
Provider Name (Legal Business Name): THE STUDIO MEDICAL SPA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 ATLANTIC ST
STAMFORD CT
06901-2414
US

IV. Provider business mailing address

36 ATLANTIC ST
STAMFORD CT
06901-2414
US

V. Phone/Fax

Practice location:
  • Phone: 203-614-8679
  • Fax:
Mailing address:
  • Phone: 203-614-8679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AISHA STROOP
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 203-614-8679