Healthcare Provider Details

I. General information

NPI: 1437044831
Provider Name (Legal Business Name): MEREDITH STECZKOWSKI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1046 RIDGE AVE SW # 4
ATLANTA GA
30315-1640
US

IV. Provider business mailing address

1046 RIDGE AVE SW # 4
ATLANTA GA
30315-1640
US

V. Phone/Fax

Practice location:
  • Phone: 404-688-1350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT003765
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901005885
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: