National Provider Identifier
Stephanie Heise, PA-C
Stephanie Heise, PA-C is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Lakewood, NY and a listed phone number of (716) 526-0156.
Profile Overview
- NPI
- 1053717165
- Provider Type
- Individual
- Primary Specialty
- Medical Physician Assistant
- Enumeration Date
- November 17, 2014
- Last Updated
- November 09, 2021
Practice Location
- 390 East Fairmount Ave
- Lakewood, NY 14750
Phone: (716) 526-0156
Mailing Address
- 390 East Fairmount
- Lakewood, NY 14750
Specialties
- Medical Physician Assistant (363AM0700X)
Full Record
- NPI
- 1053717165
- Entity Type
- Individual
- Last Name
- Heise
- First Name
- Stephanie
- Credential
- PA-C
- Mailing Street Address
- 390 East Fairmount
- Mailing City
- Lakewood
- Mailing State
- NY
- Mailing ZIP Code
- 14750
- Mailing Country
- US
- Mailing Phone
- (716) 526-0156
- Practice Street Address
- 390 East Fairmount Ave
- Practice City
- Lakewood
- Practice State
- NY
- Practice ZIP Code
- 14750
- Practice Country
- US
- Practice Phone
- (716) 526-0156
- Enumeration Date
- November 17, 2014
- Last Updated
- November 09, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- October 05, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Medical Physician Assistant (363AM0700X)