Individual
MEREDITH STALLONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14500 99TH AVE N STE 100, MAPLE GROVE, MN 55369-4738
(763) 898-1000
Mailing address
57 BENSON AVE, SAYVILLE, NY 11782-2916
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV008777
NY
Other
Enumeration date
05/28/2018
Last updated
11/21/2019
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