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General NPI Number Information
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NPI Number | 1285670588
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Entity Type | Individual
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Provider Name | VENESSA LYNN STINVIL O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 04/09/2024
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Provider Practice Location Address
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Address Line | 4 SAGAMORE LN
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City | DIX HILLS
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State | NY
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Zip | 11746-6014
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Country | US
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Telephone | 631-836-9100
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Fax | 631-253-4101
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Provider Business Mailing Address
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Address Line | 4 SAGAMORE LN
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City | DIX HILLS
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State | NY
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Zip | 11746-6014
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Country | US
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Telephone | 631-836-9100
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Fax | 631-253-4101
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18004477A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG003729
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TPOP37
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV005425
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License Number State | NY
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