Healthcare Provider Details

I. General information

NPI: 1326995762
Provider Name (Legal Business Name): LORENZO GIANLUCA STAMPONE OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 SICOMAC RD STE 204
NORTH HALEDON NJ
07508-2954
US

IV. Provider business mailing address

33 SICOMAC RD STE 204
NORTH HALEDON NJ
07508-2954
US

V. Phone/Fax

Practice location:
  • Phone: 973-427-7801
  • Fax: 973-427-7969
Mailing address:
  • Phone: 973-427-7801
  • Fax: 973-427-7969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number27OA00742600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: