Provider Demographics
NPI:1588112734
Name:LOVETT-STANDISH, STEPHANIE BETH (OD, MBA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:BETH
Last Name:LOVETT-STANDISH
Suffix:
Gender:F
Credentials:OD, MBA
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:BETH
Other - Last Name:LOVETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2142 PENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526
Mailing Address - Country:US
Mailing Address - Phone:585-377-7090
Mailing Address - Fax:585-377-3155
Practice Address - Street 1:2142 PENFIELD RD
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526
Practice Address - Country:US
Practice Address - Phone:585-377-7090
Practice Address - Fax:585-377-3155
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008523152W00000X
NYTUV008523152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist