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General NPI Number Information
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NPI Number | 1417248279
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Entity Type | Individual
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Provider Name | ROBERT JAMES STACHOWIAK PT,DPT
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Gender | Male
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 2700 N FOREST RD
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City | GETZVILLE
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State | NY
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Zip | 14068-1527
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Country | US
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Telephone | 386-956-4395
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Fax | 386-944-7202
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Provider Business Mailing Address
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Address Line | 290 OAKWOOD DR
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-7050
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Country | US
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Telephone | 716-639-3311
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Fax | 716-639-3309
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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 | PT020929
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 033021
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License Number State | NY
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