Provider Demographics
NPI:1235183963
Name:STIMLER-LEVY, LAUREN G (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:G
Last Name:STIMLER-LEVY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-3822
Mailing Address - Country:US
Mailing Address - Phone:516-872-3100
Mailing Address - Fax:516-568-0876
Practice Address - Street 1:125 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-3822
Practice Address - Country:US
Practice Address - Phone:516-872-3100
Practice Address - Fax:516-568-0876
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172110208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02722732Medicaid