Provider Demographics
NPI:1730360322
Name:FROMMELT, STEPHANIE ELAINE (MA, CCCA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ELAINE
Last Name:FROMMELT
Suffix:
Gender:F
Credentials:MA, CCCA
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ELAINE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA,CCCA
Mailing Address - Street 1:43 PINESBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4333
Mailing Address - Country:US
Mailing Address - Phone:914-819-3898
Mailing Address - Fax:914-944-1557
Practice Address - Street 1:2017 WILLIAMSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-678-8277
Practice Address - Fax:718-678-8278
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-25
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000970231H00000X, 237600000X
NY14000012300237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1578545588OtherSONOTONE ON THE HUDSON INC
NY01142507Medicaid
NYWXM321Medicare PIN
NYR45347Medicare UPIN