Provider Demographics
NPI:1952738973
Name:STEWART, MAHLON K (PT, DPT, GCS)
Entity type:Individual
Prefix:DR
First Name:MAHLON
Middle Name:K
Last Name:STEWART
Suffix:
Gender:M
Credentials:PT, DPT, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 E 10TH ST
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6221
Mailing Address - Country:US
Mailing Address - Phone:917-533-4166
Mailing Address - Fax:917-300-0376
Practice Address - Street 1:50 E 10TH ST
Practice Address - Street 2:SUITE 2E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6221
Practice Address - Country:US
Practice Address - Phone:917-533-4166
Practice Address - Fax:917-300-0376
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0306892251G0304X
NJ40QA012883002251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics