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General NPI Number Information
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NPI Number | 1043244312
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Entity Type | Individual
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Provider Name | STEPHEN GEORGE
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 10347 BANCROFT LN
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City | FRISCO
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State | TX
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Zip | 75035-2284
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Country | US
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Telephone | 516-322-0329
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Fax | 516-322-0329
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Provider Business Mailing Address
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Address Line | 215 WHITE RD
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City | MINEOLA
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State | NY
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Zip | 11501-2249
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Country | US
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Telephone | 516-322-0329
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 025994-1
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License Number State | NY
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