Provider Demographics
NPI:1598028730
Name:METZ, STEPHANIE ALAIN (MED)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ALAIN
Last Name:METZ
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 CLARA BARTON ST
Mailing Address - Street 2:
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-1520
Mailing Address - Country:US
Mailing Address - Phone:585-335-5615
Mailing Address - Fax:
Practice Address - Street 1:31 CLARA BARTON ST
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-1520
Practice Address - Country:US
Practice Address - Phone:585-335-5615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY544021111174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist