Provider Demographics
NPI:1487602272
Name:STOLFO, LINDA MARIA (OD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:MARIA
Last Name:STOLFO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6617 FALLS OF NEUSE RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6816
Mailing Address - Country:US
Mailing Address - Phone:919-676-1300
Mailing Address - Fax:919-676-7300
Practice Address - Street 1:6617 FALLS OF NEUSE RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-6816
Practice Address - Country:US
Practice Address - Phone:919-676-1300
Practice Address - Fax:919-676-7300
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1675152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89015GEMedicaid
NC015GEOtherBCBS
NC015GEOtherBCBS
NC5249990001Medicare NSC
NC2337490Medicare PIN