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General NPI Number Information
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NPI Number | 1538671870
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Entity Type | Organization
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Legal Business Name | EMPIRE ORTHOPEDIC PHYSICAL THERAPY AND REHABILITATION, PLLC
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Dates
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Enumeration Date | 10/26/2017
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Last Update Date | 10/26/2017
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Provider Practice Location Address
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Address Line | 15 LAKE RIDGE PLZ
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City | VALLEY COTTAGE
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State | NY
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Zip | 10989-1925
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Country | US
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Telephone | 845-535-9825
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Fax |
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Provider Business Mailing Address
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Address Line | 53 CAPRAL LN
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City | NEW CITY
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State | NY
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Zip | 10956-3523
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Country | US
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Telephone | 856-371-7775
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DAVID MICHAEL STEDJAN
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Credential | PT
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Telephone | 845-535-9825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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