Provider Demographics
NPI:1942369582
Name:STUART L KRIEGER & STUART M PODELL & SONIA VALLE PTR
Entity Type:Organization
Organization Name:STUART L KRIEGER & STUART M PODELL & SONIA VALLE PTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:631-499-8811
Mailing Address - Street 1:77 VETERANS MEMORIAL HWY
Mailing Address - Street 2:SUITE 6
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3410
Mailing Address - Country:US
Mailing Address - Phone:631-499-8811
Mailing Address - Fax:631-499-8846
Practice Address - Street 1:77 VETERANS MEMORIAL HWY
Practice Address - Street 2:SUITE 6
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3410
Practice Address - Country:US
Practice Address - Phone:631-499-8811
Practice Address - Fax:631-499-8846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0340770001Medicare NSC
NYC0W301Medicare PIN