Provider Demographics
NPI:1225095706
Name:HUFFMAN, STEPHANIE TARBELL (RPA-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:TARBELL
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2952
Mailing Address - Country:US
Mailing Address - Phone:585-872-2273
Mailing Address - Fax:
Practice Address - Street 1:1065 RIDGE RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2952
Practice Address - Country:US
Practice Address - Phone:585-872-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10026363A00000X
NY010026363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP019010026OtherBLUE CHOICE
NYPA0436OtherPREFERRED CARE
NY02616948Medicaid
NY000925935001OtherHEALTHNOW
NYPA0505Medicare PIN
NYPA0436OtherPREFERRED CARE