1780687731 NPI number — DR. ARLENE BETH STAUBSINGER PH.D.

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	STAUBSINGER
Provider First Name	:	ARLENE
Provider Middle Name	:	BETH
Provider Name Prefix Text	:	DR.
Provider Name Suffix Text	:
Provider Credential Text	:	PH.D.
Provider Gender Code	:	F

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Provider Other Middle Name	:
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NPI Number	:	1780687731
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	07/08/2007
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Provider First Line Business Mailing Address	:	PO BOX 2333
Provider Second Line Business Mailing Address	:
Provider Business Mailing Address City Name	:	CLAY
Provider Business Mailing Address State Name	:	NY
Provider Business Mailing Address Postal Code	:	130412333
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	3156222636
Provider Business Mailing Address Fax Number	:	3156224676

Provider First Line Business Practice Location Address	:	8100 OSWEGO RD
Provider Second Line Business Practice Location Address	:	STE 235
Provider Business Practice Location Address City Name	:	LIVERPOOL
Provider Business Practice Location Address State Name	:	NY
Provider Business Practice Location Address Postal Code	:	130901660
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	3156222636
Provider Business Practice Location Address Fax Number	:	3156224676
Provider Enumeration Date	:	05/23/2005

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• Taxonomy code: 103TC0700X , with the licence number:  010521-1 , registered in the state of NY .
• Taxonomy code: 103TC2200X , with the licence number: 010521-1 , registered in the state of NY .
• Taxonomy code: 103TF0000X , with the licence number: 010521-1 , registered in the state of NY .
• Taxonomy code: 103T00000X , with the licence number: 010521-1 , registered in the state of NY .