Provider Demographics
NPI:1780767962
Name:NATALE, STEPHANIE I (PT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:I
Last Name:NATALE
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 1:32 GERANIUM AVE
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4631
Mailing Address - Country:US
Mailing Address - Phone:718-225-5153
Mailing Address - Fax:
Practice Address - Street 1:1 EXPRESSWAY PLZ STE 106
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2069
Practice Address - Country:US
Practice Address - Phone:516-621-2681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017884-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist