Provider Demographics
NPI:1851458731
Name:STEVENS, KRISTEN LEE (MSPTOCSDPT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LEE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MSPTOCSDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-3126
Mailing Address - Country:US
Mailing Address - Phone:412-967-9229
Mailing Address - Fax:412-967-9910
Practice Address - Street 1:107 GAMMA DR
Practice Address - Street 2:STE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2982
Practice Address - Country:US
Practice Address - Phone:412-967-0525
Practice Address - Fax:412-967-0568
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT0008932251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396632Medicare ID - Type Unspecified