Ethan Dean Stahl
Student in an Organized Health Care Education/Training Program in Bronx, NY. Individual provider (NPI-1).
NPI number1457098071
StatusActive
Last updated in NPPESMay 16, 2022
Details
- NPI
- 1457098071
- Entity type
- Individual (NPI-1)
- Name
- Ethan Dean Stahl
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 16, 2022
- Certification date
- May 16, 2022
- Last updated
- May 16, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B No · DME Yes · Home health No · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
234 E 149th StBronx, NY 10451-5504
Phone 844-692-4692
Mailing address
256 Henry St Apt 4Brooklyn, NY 11201-4653
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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