Provider Demographics
NPI:1134713514
Name:STELLAROPTIX LLC
Entity type:Organization
Organization Name:STELLAROPTIX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-279-7101
Mailing Address - Street 1:875 NORMAN DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7454
Mailing Address - Country:US
Mailing Address - Phone:717-272-2010
Mailing Address - Fax:
Practice Address - Street 1:875 NORMAN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7454
Practice Address - Country:US
Practice Address - Phone:717-279-7101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty