Provider Demographics
NPI:1467257915
Name:OOLUP, STEPHANI HELEN (PT)
Entity type:Individual
Prefix:
First Name:STEPHANI
Middle Name:HELEN
Last Name:OOLUP
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W 10TH ST APT 3G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10014-6413
Mailing Address - Country:US
Mailing Address - Phone:647-968-4104
Mailing Address - Fax:
Practice Address - Street 1:2 W 45TH ST STE 201
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4269
Practice Address - Country:US
Practice Address - Phone:734-236-6394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0539102251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic