Healthcare Provider Details

I. General information

NPI: 1982865564
Provider Name (Legal Business Name): STEPHANIE G MIDGLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE G SIPPEL MD

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 FIREMENS WAY
POUGHKEEPSIE NY
12603-6524
US

IV. Provider business mailing address

PO BOX 9484
PROVIDENCE RI
02940-9484
US

V. Phone/Fax

Practice location:
  • Phone: 718-759-7658
  • Fax: 833-438-1827
Mailing address:
  • Phone: 401-854-2501
  • Fax: 401-854-2519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberLP01320
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number269408
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD13926
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: