Provider Demographics
NPI:1760813497
Name:ZWERLING, STEPHANIE (PTA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:ZWERLING
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 POST AVE
Mailing Address - Street 2:APT #213
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-3283
Mailing Address - Country:US
Mailing Address - Phone:516-448-4226
Mailing Address - Fax:
Practice Address - Street 1:180 E PULASKI RD
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-1915
Practice Address - Country:US
Practice Address - Phone:631-396-1595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-05
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009100225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant