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General NPI Number Information
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NPI Number | 1508863507
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Entity Type | Organization
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Legal Business Name | STEPHEN W. BASSIN, P.T., P.C.
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 32 SHERMAN AVE
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City | GLENS FALLS
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State | NY
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Zip | 12801-2839
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Country | US
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Telephone | 518-793-7136
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Fax | 518-793-7142
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Provider Business Mailing Address
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Address Line | 32 SHERMAN AVE
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City | GLENS FALLS
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State | NY
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Zip | 12801-2839
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Country | US
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Telephone | 518-793-7136
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Fax | 518-793-7142
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Authorized Official
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Title or Position | PRESIDENT, PHYSICAL THERAPIST
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Name | MR. STEPHEN WAYNE BASSIN
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Credential | P.T.
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Telephone | 518-793-7136
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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 |
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License Number State |
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