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General NPI Number Information
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NPI Number | 1407269590
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Entity Type | Organization
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Legal Business Name | YOLANDA STAHL DPM PC
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Dates
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Enumeration Date | 06/05/2014
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 1457 MERRICK AVE
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City | MERRICK
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State | NY
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Zip | 11566
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Country | US
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Telephone | 576-379-0815
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Fax | 576-379-0872
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Provider Business Mailing Address
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Address Line | 1457 MERRICK AVE
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City | MERRICK
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State | NY
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Zip | 11566
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Country | US
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Telephone | 576-379-0815
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Fax | 576-379-0872
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. YOLANDA STAHL
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Credential | DPM
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Telephone | 576-379-0815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | N005672
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N0056720
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License Number State | NY
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