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General NPI Number Information
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NPI Number | 1255934998
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Entity Type | Individual
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Provider Name | STEPHANIE L PIRGER
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Gender | Female
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Dates
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Enumeration Date | 11/17/2020
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 1 CAMPUS RD
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City | STATEN ISLAND
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State | NY
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Zip | 10301-4495
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Country | US
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Telephone | 718-420-4044
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Fax |
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Provider Business Mailing Address
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Address Line | 47 PERONA LN
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City | STATEN ISLAND
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State | NY
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Zip | 10308-3323
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Country | US
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Telephone | 860-694-8098
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 004514-01
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License Number State | NY
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