Individual
KIMBERLY STACEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
481 SUNRISE HWY, LYNBROOK, NY 11563-3017
(516) 504-3203
Mailing address
5 NORTH BLVD, EAST ROCKAWAY, NY 11518-1802
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5379
NY
Other
Enumeration date
12/23/2013
Last updated
01/08/2016
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