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General NPI Number Information
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NPI Number | 1881410611
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Entity Type | Individual
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Provider Name | AUSTIN STOCKERT DPT
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Gender | Male
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 7 S CANAL ST STE 101
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City | GREENE
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State | NY
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Zip | 13778-1288
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Country | US
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Telephone | 607-656-4464
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Fax | 607-656-4593
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Provider Business Mailing Address
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Address Line | PO BOX 613
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City | GREENE
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State | NY
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Zip | 13778-0613
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Country | US
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Telephone | 607-656-4464
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Fax | 607-656-4593
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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 | 052901
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License Number State | NY
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