Provider Demographics
NPI:1952679961
Name:SUTERA, STEFANIE ANNE (DPT)
Entity Type:Individual
Prefix:MISS
First Name:STEFANIE
Middle Name:ANNE
Last Name:SUTERA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 HAMBURG TPKE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2098
Mailing Address - Country:US
Mailing Address - Phone:973-636-6550
Mailing Address - Fax:973-636-9461
Practice Address - Street 1:701 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2098
Practice Address - Country:US
Practice Address - Phone:973-636-6550
Practice Address - Fax:973-636-9461
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA014249002251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic