Provider Demographics
NPI:1942652052
Name:STOLZ, ANDREA VALENTI (NPP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:VALENTI
Last Name:STOLZ
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7432 COUNTY HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-8216
Mailing Address - Country:US
Mailing Address - Phone:315-258-2171
Mailing Address - Fax:
Practice Address - Street 1:7432 COUNTY HOUSE RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-8216
Practice Address - Country:US
Practice Address - Phone:315-258-2171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-13
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY40231363LP0808X
NY402031363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health