Provider Demographics
NPI:1821897547
Name:STEPHANIE MIDGLEY MEDICINE PC
Entity type:Organization
Organization Name:STEPHANIE MIDGLEY MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-759-7658
Mailing Address - Street 1:26 SPY GLASS HL
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JCT
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6274
Mailing Address - Country:US
Mailing Address - Phone:718-759-7658
Mailing Address - Fax:
Practice Address - Street 1:232 NEW HACKENSACK RD
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-1408
Practice Address - Country:US
Practice Address - Phone:718-759-7658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine