Healthcare Provider Details

I. General information

NPI: 1144407867
Provider Name (Legal Business Name): MARK STEMPLER, D.P.M.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2627 HYLAN BLVD BLDG D
STATEN ISLAND NY
10306-4339
US

IV. Provider business mailing address

2627 HYLAN BLVD BLDG D
STATEN ISLAND NY
10306-4339
US

V. Phone/Fax

Practice location:
  • Phone: 718-667-6333
  • Fax: 718-987-6648
Mailing address:
  • Phone: 718-667-6333
  • Fax: 718-987-6648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN004914
License Number StateNY

VIII. Authorized Official

Name: DR. MARK MITCHELL STEMPLER
Title or Position: OWNER
Credential: D.P.M
Phone: 718-667-6333