Provider Demographics
NPI:1033258009
Name:STOEBE, DANIELLE FAYE (RPA-C)
Entity Type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:FAYE
Last Name:STOEBE
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:FAYE
Other - Last Name:WRUBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:185 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2121
Mailing Address - Country:US
Mailing Address - Phone:631-298-4479
Mailing Address - Fax:631-591-3047
Practice Address - Street 1:54 WOODVILLE RD
Practice Address - Street 2:
Practice Address - City:SHOREHAM
Practice Address - State:NY
Practice Address - Zip Code:11786-1331
Practice Address - Country:US
Practice Address - Phone:631-929-1256
Practice Address - Fax:631-929-8313
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010778363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical