Provider Demographics
NPI:1407032790
Name:STEWART, HEATHER K (PT, MPT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:K
Last Name:STEWART
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14787-1104
Mailing Address - Country:US
Mailing Address - Phone:716-793-2231
Mailing Address - Fax:716-793-2312
Practice Address - Street 1:189 E MAIN ST
Practice Address - Street 2:WESTFIELD MEMORIAL HOSPITAL
Practice Address - City:WESTFIELD
Practice Address - State:NY
Practice Address - Zip Code:14787-1104
Practice Address - Country:US
Practice Address - Phone:716-793-2231
Practice Address - Fax:716-793-2312
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22094225100000X
NY30942225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist