Provider Demographics
NPI:1912986704
Name:STAHARA, ROBERT C (PT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:STAHARA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1179 GROUSE RUN DR
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-3233
Mailing Address - Country:US
Mailing Address - Phone:412-835-8351
Mailing Address - Fax:
Practice Address - Street 1:2550 MOSSIDE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3540
Practice Address - Country:US
Practice Address - Phone:412-374-7255
Practice Address - Fax:412-374-0220
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT-006307-L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist