Provider Demographics
NPI:1710312152
Name:ABRAITIS, STEPHANIE (CM)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ABRAITIS
Suffix:
Gender:F
Credentials:CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-8916
Mailing Address - Country:US
Mailing Address - Phone:845-354-9300
Mailing Address - Fax:
Practice Address - Street 1:728 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW SQUARE
Practice Address - State:NY
Practice Address - Zip Code:10977-8916
Practice Address - Country:US
Practice Address - Phone:845-354-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF001595176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife