Provider Demographics
NPI:1861796773
Name:GEAREY, STEPHEN ANDREW (MSPT)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:ANDREW
Last Name:GEAREY
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:GEAREY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSPT
Mailing Address - Street 1:535 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974
Mailing Address - Country:US
Mailing Address - Phone:908-312-5315
Mailing Address - Fax:908-829-0671
Practice Address - Street 1:535 MOUNTAIN AVE
Practice Address - Street 2:LANTERN HILL
Practice Address - City:NEW PROVIDENCE
Practice Address - State:NJ
Practice Address - Zip Code:07974
Practice Address - Country:US
Practice Address - Phone:908-312-5315
Practice Address - Fax:908-829-0671
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00894700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist