Healthcare Provider Details

I. General information

NPI: 1578836730
Provider Name (Legal Business Name): STEPHEN MICHAEL STYLINSKI PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2012
Last Update Date: 02/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

546 N HYDE PARK AVE
SCRANTON PA
18504-1844
US

IV. Provider business mailing address

546 N HYDE PARK AVE
SCRANTON PA
18504-1844
US

V. Phone/Fax

Practice location:
  • Phone: 570-878-4209
  • Fax:
Mailing address:
  • Phone: 570-878-4209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT001500E
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: