Healthcare Provider Details

I. General information

NPI: 1316879059
Provider Name (Legal Business Name): STEPHEN BINGEL DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 HUMPHREY ST
SWAMPSCOTT MA
01907-2618
US

IV. Provider business mailing address

PO BOX 322
BOSTON MA
02134-0003
US

V. Phone/Fax

Practice location:
  • Phone: 617-987-0040
  • Fax: 617-623-4224
Mailing address:
  • Phone: 617-978-0040
  • Fax: 617-623-4224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number89109
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: