MEDICARE: ALPHA THERAPY SERVICES PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	40QA008848	NJ

General Provider Information

NPI Number	:	1013186139
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHA THERAPY SERVICES PA

Provider Business Mailing Address
First Line	:	22 JACKSON AVE
Second Line	:
City	:	POMPTON PLAINS
State	:	NJ
Zip	:	07444-1416
Country	:	US
Telephone Number	:	973-513-9055
Fax Number	:	973-513-9056

Provider Business Practice Location Address
First Line	:	22 JACKSON AVE
Second Line	:
City	:	POMPTON PLAINS
State	:	NJ
Zip	:	07444-1447
Country	:	US
Telephone Number	:	973-513-9055
Fax Number	:	973-513-9056

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANGELO ANASTASSIOS STEFANIDES
Credential	:	PT
Telephone Number	:	973-768-7247

Provider Enumeration Date	:	02/22/2008
Last Update Date	:	05/12/2014

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Directions to “ALPHA THERAPY SERVICES PA ” Practice Location

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