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NPI Code Detail

MEDICARE: RYAN ANTHONY STAHL PT, DPT

MEDICARE: RYAN ANTHONY STAHL PT, DPT
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
1225100000XPhysical Therapist40QA01784600NJ

General Provider Information

NPI Number : 1700383221
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN ANTHONY STAHL PT, DPT
Provider Business Mailing Address
First Line : 1377 MOTOR PKWY STE 307
Second Line :
City : ISLANDIA
State : NY
Zip : 11749-5258
Country : US
Telephone Number : 631-580-5200
Fax Number : 631-760-8306
Provider Business Practice Location Address
First Line : 1436 ROUTE 70 E
Second Line :
City : CHERRY HILL
State : NJ
Zip : 08034-2244
Country : US
Telephone Number : 856-429-8000
Fax Number : 856-429-8003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2018
Last Update Date : 08/31/2020

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