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NPI 1508119678

NPI 1508119678 : ALEXANDER JOHN STABILE : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1508119678
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    Entity Type          |    Individual 
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    Provider Name        |    ALEXANDER JOHN STABILE
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/25/2012
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    Last Update Date     |    04/17/2016
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Provider Practice Location Address
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    Address Line         |    210 E 86TH ST SUITE 502
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10028-3003
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    Country              |    US
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    Telephone            |    212-249-0904
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    210 E 86TH ST RM 502
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10028-7725
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    Country              |    US
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    Telephone            |    516-238-3314
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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        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    016721
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    License Number State |    NY
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