Healthcare Provider Details

I. General information

NPI: 1508863507
Provider Name (Legal Business Name): STEPHEN W. BASSIN, P.T., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 SHERMAN AVE
GLENS FALLS NY
12801-2839
US

IV. Provider business mailing address

32 SHERMAN AVE
GLENS FALLS NY
12801-2839
US

V. Phone/Fax

Practice location:
  • Phone: 518-793-7136
  • Fax: 518-793-7142
Mailing address:
  • Phone: 518-793-7136
  • Fax: 518-793-7142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN WAYNE BASSIN
Title or Position: PRESIDENT, PHYSICAL THERAPIST
Credential: P.T.
Phone: 518-793-7136