Provider Demographics
NPI:1215361647
Name:STAMATINOS, GEORGE M (DPT)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:M
Last Name:STAMATINOS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 ROUTE 9 N STE 410
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-1003
Mailing Address - Country:US
Mailing Address - Phone:201-801-7141
Mailing Address - Fax:732-218-5322
Practice Address - Street 1:254 TEXAS RD
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-4008
Practice Address - Country:US
Practice Address - Phone:732-561-3401
Practice Address - Fax:732-561-3402
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036653225100000X
NJ40QA01931000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist