Provider Demographics
NPI:1134734478
Name:NARDOZZI, STEPHANIE (LMT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:NARDOZZI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-2319
Mailing Address - Country:US
Mailing Address - Phone:914-391-3646
Mailing Address - Fax:
Practice Address - Street 1:175 TOMPKINS AVE
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-3144
Practice Address - Country:US
Practice Address - Phone:914-202-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist