Provider Demographics
NPI:1538372123
Name:KIRSHEN, STEPHEN ANDREW (OD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ANDREW
Last Name:KIRSHEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2365 HEMPSTEAD TPKE
Mailing Address - Street 2:PEARLE VISION
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-2027
Mailing Address - Country:US
Mailing Address - Phone:516-796-3800
Mailing Address - Fax:515-796-3802
Practice Address - Street 1:2365 HEMPSTEAD TPKE
Practice Address - Street 2:PEARLE VISION
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-2027
Practice Address - Country:US
Practice Address - Phone:516-796-3800
Practice Address - Fax:515-796-3802
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT004791-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist