Provider Demographics
NPI:1851694087
Name:STEGEN AND ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:STEGEN AND ASSOCIATES, PLLC
Other - Org Name:NORTH COUNTRY EYE CARE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:STEGEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:603-298-8064
Mailing Address - Street 1:33 LIBRARY RD.
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:NH
Mailing Address - Zip Code:03240-3446
Mailing Address - Country:US
Mailing Address - Phone:603-523-4947
Mailing Address - Fax:603-523-4947
Practice Address - Street 1:200 S MAIN ST
Practice Address - Street 2:SUITE 11
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-2014
Practice Address - Country:US
Practice Address - Phone:603-298-8064
Practice Address - Fax:603-298-7898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH592152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHU32728Medicare UPIN