Provider Demographics
NPI:1821359480
Name:STANO, ALEX FARRELL (DPT)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:FARRELL
Last Name:STANO
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 1:34 STRATTON LN
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-3222
Mailing Address - Country:US
Mailing Address - Phone:631-681-6662
Mailing Address - Fax:
Practice Address - Street 1:34 STRATTON LN
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-3222
Practice Address - Country:US
Practice Address - Phone:631-681-6662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034858225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist