Provider Demographics
NPI:1194179242
Name:STEVEN PALEY OD, INC.
Entity Type:Organization
Organization Name:STEVEN PALEY OD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PALEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:646-408-0036
Mailing Address - Street 1:280 ARROYO PINON DR
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5055
Mailing Address - Country:US
Mailing Address - Phone:646-408-0036
Mailing Address - Fax:928-541-9873
Practice Address - Street 1:1280 GAIL GARDNER WAY
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-1641
Practice Address - Country:US
Practice Address - Phone:928-541-7767
Practice Address - Fax:928-541-9873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2020152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU95249Medicare UPIN