Provider Demographics
NPI:1043568306
Name:DELVECCHIO, STEPHANIE RENEE (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:RENEE
Last Name:DELVECCHIO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:STEPHANIE
Other - Middle Name:RENEE
Other - Last Name:NEBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1402 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-1624
Mailing Address - Country:US
Mailing Address - Phone:814-432-5121
Mailing Address - Fax:814-432-5121
Practice Address - Street 1:261 SUNSET DR
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-1313
Practice Address - Country:US
Practice Address - Phone:724-283-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002687152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist