Active NPI
Stephen E Fadullon, R.P.T
- Physical Therapist
- East Stroudsburg, PA
National Provider Identifier
1477593309
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT011509L
- Practice address
- 3 Parkinson Rd
East Stroudsburg, PA 18301-8087 - Phone
- (570) 517-5113
- NPI assigned
- Jun 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT011509L | PA | Primary |
Addresses
Primary practice location
3 Parkinson Rd
East Stroudsburg, PA 18301-8087
Mailing address
916 Saw Creek Est
Bushkill, PA 18324-9462
Phone (570) 588-4094
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT011509L | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1477593309",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916 SAW CREEK EST",
"city": "BUSHKILL",
"state": "PA",
"postal_code": "183249462",
"telephone_number": "570-588-4094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 PARKINSON RD",
"city": "EAST STROUDSBURG",
"state": "PA",
"postal_code": "183018087",
"telephone_number": "570-517-5113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FADULLON",
"first_name": "STEPHEN",
"middle_name": "E",
"credential": "R.P.T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT011509L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Stroudsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.