Provider Demographics
NPI:1841678927
Name:LEE-MAIER, STELLA S (OD)
Entity type:Individual
Prefix:
First Name:STELLA
Middle Name:S
Last Name:LEE-MAIER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:STELLA
Other - Middle Name:
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1 WILSON DR
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-4416
Mailing Address - Country:US
Mailing Address - Phone:973-579-2020
Mailing Address - Fax:973-579-2021
Practice Address - Street 1:1 WILSON DR
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-4416
Practice Address - Country:US
Practice Address - Phone:973-579-2020
Practice Address - Fax:973-579-2021
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00660200152W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes152W00000XEye and Vision Services ProvidersOptometrist