Provider Demographics
NPI:1790859254
Name:STECKER, SLOANE TODD (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:SLOANE
Middle Name:TODD
Last Name:STECKER
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 MCLEAN AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-4740
Mailing Address - Country:US
Mailing Address - Phone:914-375-3402
Mailing Address - Fax:914-375-3402
Practice Address - Street 1:630 MCLEAN AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-4740
Practice Address - Country:US
Practice Address - Phone:914-375-3402
Practice Address - Fax:914-375-3402
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15801225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3C8125OtherHEALTHNET
NYSC3890OtherMULTIPLAN
NY174127POtherHIP
NYQ25M51OtherBLUE CROSS BLUE SHIELD
NY4914373OtherCIGNA
NYQ6W8B1Medicare ID - Type Unspecified
NY3C8125OtherHEALTHNET