Stephanie Wellbrock

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

1 Industrial Blvd
Medford, NY 11763-2220

Phone

(631) 297-3202

Fax

(631) 205-1763

NPI assigned

Jun 3, 2026

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1336071125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ACADEMY ST",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051706",
            "telephone_number": "631-297-3202",
            "fax_number": "631-205-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 INDUSTRIAL BLVD",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632220",
            "telephone_number": "631-297-3202",
            "fax_number": "631-205-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLBROCK",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-03",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen Washington
• Keith Watkins, LMSW
• Lauren Wavra
• Ira P Wechterman, DDS
• Jennifer Weisberg, MS.ED.
• Jennifer Wellman, OTR/L
• Craig Barry Wexler, M.D.
• Renee Whitman, LMHC
• Talisa Lachelle Wilkes, RN
• Lisa Susan Williams, AGPCNP

• Specialist in Medford, NY
• Providers in Medford, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.