Mary E Stupczy, PT

Individual provider Active NPI Physical Therapist · Brook Park, OH

NPI 1467640201 · NPPES record last updated Oct 5, 2007

Key facts

NPI
1467640201
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT011921 (OH)
Practice address
15900 Snow Rd
Brook Park, OH 44142-2859
Phone
(216) 896-0824
Fax
(216) 896-0825
NPI assigned
Oct 5, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT011921 OH Yes

Addresses

Primary practice location

15900 Snow Rd
Brook Park, OH 44142-2859

Mailing address

12208 Thraves Ave
Garfield HTS, OH 44125-4350
Phone (330) 714-3592

Other providers in Brook Park, OH

All providers in Brook Park, OH · Physical Therapist in Ohio

Sources for this page

Verify at the official NPI Registry.