Provider Demographics
NPI:1144537929
Name:BEDNARSKI, STEPHANIE BETH (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:BETH
Last Name:BEDNARSKI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 JACKSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1504
Mailing Address - Country:US
Mailing Address - Phone:973-580-2102
Mailing Address - Fax:
Practice Address - Street 1:1 BROADWAY, SUITE 301
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-1845
Practice Address - Country:US
Practice Address - Phone:201-791-0707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01362100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist