Healthcare Provider Details

I. General information

NPI: 1245093061
Provider Name (Legal Business Name): STABLE FRIENDSHIPS FOUNDATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 GUARD HILL RD
MOUNT KISCO NY
10549-4943
US

IV. Provider business mailing address

40 VILLAGE GRN UNIT 14
BEDFORD NY
10506-7001
US

V. Phone/Fax

Practice location:
  • Phone: 914-420-3802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LYDIA STERNFELD
Title or Position: SECRETARY
Credential: OTR
Phone: 914-420-3802