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General NPI Number Information
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NPI Number | 1396439766
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN MANGELS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 03/09/2025
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Provider Practice Location Address
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Address Line | 214 VINE ST # 303
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City | PHILADELPHIA
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State | PA
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Zip | 19106-1213
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Country | US
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Telephone | 203-505-0264
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Fax |
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Provider Business Mailing Address
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Address Line | 214 VINE ST # 303
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City | PHILADELPHIA
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State | PA
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Zip | 19106-1213
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Country | US
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Telephone | 203-505-0264
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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 | 40QA02176400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 40QA02176400
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License Number State | NJ
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