Healthcare Provider Details

I. General information

NPI: 1366714081
Provider Name (Legal Business Name): STELLAR PHYSICAL & OCCUPATIONAL THERAPY & ACUPUNCTURE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8709 JUSTICE AVE
ELMHURST NY
11373-4556
US

IV. Provider business mailing address

8709 JUSTICE AVE
ELMHURST NY
11373-4556
US

V. Phone/Fax

Practice location:
  • Phone: 718-699-5070
  • Fax: 718-699-5071
Mailing address:
  • Phone: 718-699-5070
  • Fax: 718-699-5071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number027453
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number035391
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number014057
License Number StateNY

VIII. Authorized Official

Name: ANDREW NICHOLAS WOOLWARD
Title or Position: OCCUPATIONAL THERAPIST/OWNER
Credential: OT
Phone: 347-512-5674