Provider Demographics
NPI:1972900843
Name:JOHNS, STEFANIE (PT)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:JOHNS
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 1:444 E 84TH ST APT 7B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-6241
Mailing Address - Country:US
Mailing Address - Phone:908-268-7674
Mailing Address - Fax:
Practice Address - Street 1:3 HUNTINGTON QUADRANGLE STE 103
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4602
Practice Address - Country:US
Practice Address - Phone:855-487-3422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY62038297225100000X
2251X0800X
NY038297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic