Healthcare Provider Details

I. General information

NPI: 1023766151
Provider Name (Legal Business Name): STEVEN WILLIAM SPLECHTER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2022
Last Update Date: 03/17/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 SUBURBAN PKWY FL 2
WARWICK RI
02889-9631
US

IV. Provider business mailing address

151 SUBURBAN PKWY FL 2
WARWICK RI
02889-9631
US

V. Phone/Fax

Practice location:
  • Phone: 401-218-3107
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA01307
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: