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General NPI Number Information
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NPI Number | 1457951204
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Entity Type | Individual
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Provider Name | STEPHANIE SHARYN ANDERSON PTA
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Gender | Female
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Dates
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Enumeration Date | 10/30/2020
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Last Update Date | 10/30/2020
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Provider Practice Location Address
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Address Line | 13 HAKIM ST
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City | DANBURY
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State | CT
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Zip | 06810-5316
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Country | US
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Telephone | 203-744-3366
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Fax |
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Provider Business Mailing Address
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Address Line | 29 GREENWOOD AVE
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City | BETHEL
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State | CT
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Zip | 06801-2204
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Country | US
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Telephone | 845-702-5269
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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