Provider Demographics
NPI:1477790582
Name:FRANK, STEPHEN C (PT)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:C
Last Name:FRANK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:STEPHEN
Other - Middle Name:C
Other - Last Name:FRANK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:66 SUNSET STRIP
Mailing Address - Street 2:SUITE 409
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1345
Mailing Address - Country:US
Mailing Address - Phone:973-252-9292
Mailing Address - Fax:973-252-9377
Practice Address - Street 1:66 SUNSET STRIP
Practice Address - Street 2:SUITE 409
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1345
Practice Address - Country:US
Practice Address - Phone:973-252-9292
Practice Address - Fax:973-252-9377
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00047900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ316549Medicare PIN