Provider Demographics
NPI:1558123836
Name:VALDES, STEPHEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:VALDES
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:637 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-4004
Mailing Address - Country:US
Mailing Address - Phone:203-276-2634
Mailing Address - Fax:203-276-2624
Practice Address - Street 1:637 WEST AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-4004
Practice Address - Country:US
Practice Address - Phone:203-276-2634
Practice Address - Fax:203-276-2624
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT137962251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic