Healthcare Provider Details

I. General information

NPI: 1083322879
Provider Name (Legal Business Name): NICOLE ELIZABETH STENGEL DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2022
Last Update Date: 11/09/2022
Certification Date: 11/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 CORPORATE DR STE 100
PITTSBURGH PA
15237-7012
US

IV. Provider business mailing address

54 FOUNTAIN ST
PITTSBURGH PA
15205-3330
US

V. Phone/Fax

Practice location:
  • Phone: 412-369-7735
  • Fax:
Mailing address:
  • Phone: 412-925-9767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT030913
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: