Provider Demographics
NPI:1558744375
Name:STABILE, MAURA
Entity Type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:
Last Name:STABILE
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:CALLE MANUELA WALKER A-26 #2
Mailing Address - Street 2:URB ROLLING HILLS, CARR 860
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-242-1920
Mailing Address - Fax:
Practice Address - Street 1:CALLE MANUELA WALKER A-26 #2
Practice Address - Street 2:URB ROLLING HILLS, CARR 860
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-242-1920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier