Provider Demographics
NPI:1447375795
Name:WOLMAN, STEPHANIE LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LYNN
Last Name:WOLMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 OLD MAMARONECK RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-3212
Mailing Address - Country:US
Mailing Address - Phone:914-261-0341
Mailing Address - Fax:
Practice Address - Street 1:550 MAMARONECK AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1634
Practice Address - Country:US
Practice Address - Phone:914-777-5767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006082152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy