Provider Demographics
NPI:1396071262
Name:TREBING, STACY LYNN (PT)
Entity type:Individual
Prefix:MS
First Name:STACY
Middle Name:LYNN
Last Name:TREBING
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:712 MAIN ST
Mailing Address - Street 2:PO BOX 9182
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-3620
Mailing Address - Country:US
Mailing Address - Phone:631-666-3951
Mailing Address - Fax:631-750-1177
Practice Address - Street 1:77 MEDFORD AVE
Practice Address - Street 2:ROUTE 112
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-1281
Practice Address - Country:US
Practice Address - Phone:631-758-1910
Practice Address - Fax:631-758-1984
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2016-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY0136711225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist