Provider Demographics
NPI:1821009010
Name:STELMAK, ROBYN L (PT)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:L
Last Name:STELMAK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 SAYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-4777
Mailing Address - Country:US
Mailing Address - Phone:860-638-3820
Mailing Address - Fax:860-638-3824
Practice Address - Street 1:410 SAYBROOK RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4777
Practice Address - Country:US
Practice Address - Phone:860-638-3820
Practice Address - Fax:860-638-3824
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0076122251E1200X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT650001267Medicare ID - Type Unspecified