Provider Demographics
NPI:1255861423
Name:STAUDENMAIER, EMILY K (DO)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:K
Last Name:STAUDENMAIER
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Gender:F
Credentials:DO
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Mailing Address - Street 1:230 WORCESTER ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-5420
Mailing Address - Country:US
Mailing Address - Phone:781-431-5429
Mailing Address - Fax:781-431-5548
Practice Address - Street 1:1000 MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4927
Practice Address - Country:US
Practice Address - Phone:631-376-4163
Practice Address - Fax:631-376-3420
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2021-07-06
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Provider Licenses
StateLicense IDTaxonomies
MA287120207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology