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General NPI Number Information
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NPI Number | 1275179046
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Entity Type | Individual
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Provider Name | SEAN STEWART
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Gender | Male
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Dates
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Enumeration Date | 11/26/2019
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Last Update Date | 11/26/2019
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Provider Practice Location Address
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Address Line | 131 LAWRENCE ST
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-1346
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Country | US
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Telephone | 518-587-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 273 SARATOGA AVE
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City | MECHANICVILLE
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State | NY
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Zip | 12118-1016
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Country | US
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Telephone | 518-928-7772
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 010181-01
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License Number State | NY
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