Stadlen, Mark
Stadlen, Mark is an sole proprietor health care provider with primary practice located at 3803 Broadway , Astoria NY 11103-4058. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Stadlen, Mark can be contacted via phone (718) 956-3000.Contact Information
Primary practice address
3803 Broadway
Astoria NY 11103-4058
Phone: (718) 956-3000
Fax: (718) 204-0227
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | TUV0040201 | New York |
Profile Details
| NPI number | 1942479324 |
|---|---|
| LBN Legal business name | Stadlen, Mark |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 29th, 2008 |
| Last updated | Aug 26th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942479324 | NPPES |
| New York | Other | MS0C329210 | BCBS |
| New York | MEDICAID | 00695345 | BCBS |
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