Provider Demographics
NPI:1619960499
Name:SHARKAZY, STEPHEN M (DPT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:SHARKAZY
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 1:250 CETRONIA ROAD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9168
Mailing Address - Country:US
Mailing Address - Phone:610-973-6200
Mailing Address - Fax:610-973-6533
Practice Address - Street 1:250 CETRONIA ROAD
Practice Address - Street 2:SUITE 303
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9168
Practice Address - Country:US
Practice Address - Phone:610-973-6200
Practice Address - Fax:610-973-6533
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT017515225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist