Provider Demographics
NPI:1134469174
Name:PAGE, STEFANIE ERIN
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:ERIN
Last Name:PAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:ERIN
Other - Last Name:FURLANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:46 TAY BROOK LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-3300
Mailing Address - Country:US
Mailing Address - Phone:716-432-8079
Mailing Address - Fax:
Practice Address - Street 1:46 TAY BROOK LN
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-3300
Practice Address - Country:US
Practice Address - Phone:716-432-8079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1881212174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1881212OtherTEACHING CERTIFICATE NUMBER