Provider Demographics
NPI:1386462653
Name:STROHMAIER, DEBRA J (LOD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:J
Last Name:STROHMAIER
Suffix:
Gender:F
Credentials:LOD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 NEW LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-3900
Mailing Address - Country:US
Mailing Address - Phone:518-782-0672
Mailing Address - Fax:518-785-0503
Practice Address - Street 1:800 NEW LOUDON RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-3900
Practice Address - Country:US
Practice Address - Phone:518-782-0672
Practice Address - Fax:518-785-0503
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7011-1156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician