MEDICARE: STEPHANIE HADJAIL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	044436-01	NY

General Provider Information

NPI Number	:	1295332377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE HADJAIL

Provider Business Mailing Address
First Line	:	13230 57TH AVE APT 2
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11355-5193
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3530 64TH ST
Second Line	:
City	:	NY
State	:	NY
Zip	:	11377-2354
Country	:	US
Telephone Number	:	929-398-8801
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2020
Last Update Date	:	10/28/2020

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Directions to “ STEPHANIE HADJAIL ” Practice Location

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