Provider Demographics
NPI:1477940989
Name:MERENSTEIN, STACY
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:MERENSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5510 SURREY ST
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5524
Mailing Address - Country:US
Mailing Address - Phone:202-210-9396
Mailing Address - Fax:
Practice Address - Street 1:9730 PATUXENT WOODS DR STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1626
Practice Address - Country:US
Practice Address - Phone:667-205-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT437225XP0200X
MD02822225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics