Provider Demographics
NPI:1225038102
Name:COWDEN, STEPHEN KARL (PT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:KARL
Last Name:COWDEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1363 VETERANS MEMORIAL HWY STE 30
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-3046
Mailing Address - Country:US
Mailing Address - Phone:631-622-0150
Mailing Address - Fax:631-622-0152
Practice Address - Street 1:1363 VETERANS MEMORIAL HWY STE 30
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-3046
Practice Address - Country:US
Practice Address - Phone:631-622-0150
Practice Address - Fax:631-622-0152
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010941225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4C3521OtherHEALTHNET
NYQP0191OtherBCBS
NY105179POtherHIP
NY78327OtherVYTRA
NYP2748641OtherOXFORD
NY6698753OtherGHI
NYP2748641OtherOXFORD