Provider Demographics
NPI:1851184766
Name:MUNOZ, STEPHANIE (NP)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8135 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7701
Mailing Address - Country:US
Mailing Address - Phone:518-506-1098
Mailing Address - Fax:
Practice Address - Street 1:16 SUMNER PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-4110
Practice Address - Country:US
Practice Address - Phone:718-336-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY762040163WC0200X
NY311878363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine