Provider Demographics
NPI:1356452049
Name:STEPNER, MEYER CHARLES (OD)
Entity Type:Individual
Prefix:MR
First Name:MEYER
Middle Name:CHARLES
Last Name:STEPNER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11310 BEACH CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694-2209
Mailing Address - Country:US
Mailing Address - Phone:718-474-1234
Mailing Address - Fax:718-945-5809
Practice Address - Street 1:11310 BEACH CHANNEL DR
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-2209
Practice Address - Country:US
Practice Address - Phone:718-474-1234
Practice Address - Fax:718-945-5809
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV004492-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY50988KMedicare PIN
NYC32241Medicare UPIN