Healthcare Provider Details

I. General information

NPI: 1003524257
Provider Name (Legal Business Name): LAUREN CATHERINE HENDRICK STAHLSMITH PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN CATHERINE HENDRICK PA

II. Dates (important events)

Enumeration Date: 11/07/2022
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 PARK AVE FL 20
NEW YORK NY
10016-1601
US

IV. Provider business mailing address

300 E 57TH ST APT 2H
NEW YORK NY
10022-2994
US

V. Phone/Fax

Practice location:
  • Phone: 212-972-4444
  • Fax:
Mailing address:
  • Phone: 716-490-2763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-16637
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number028799
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: