Provider Demographics
NPI:1760533749
Name:STERGAR, ROBERTA L (P T)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:L
Last Name:STERGAR
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:ROBERTA
Other - Middle Name:L
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:6900 N PECOS
Mailing Address - Street 2:BUILDING 5
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086-4400
Mailing Address - Country:US
Mailing Address - Phone:702-791-9000
Mailing Address - Fax:
Practice Address - Street 1:6900 N PECOS
Practice Address - Street 2:BUILDING 5
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-4400
Practice Address - Country:US
Practice Address - Phone:702-791-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2899225100000X
IL070012031225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL11581828OtherCAQH PROVIDER ID
NV2899OtherNEVADA STATE BOARD OF PHYSICAL THERAPY EXAMINERS
NV2899OtherNEVADA STATE BOARD OF PHYSICAL THERAPY EXAMINERS