Robert S Stasak
Individual provider Active NPI Athletic Trainer · Wind Gap, PA
NPI 1497838908 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497838908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- RT000571B (PA)
- Practice address
- 225 Oak St
Wind Gap, PA 18091-1638 - Phone
- (610) 863-4604
- NPI assigned
- Oct 21, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT000571B | PA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT000571B | PA | Yes |
Addresses
Primary practice location
225 Oak St
Wind Gap, PA 18091-1638
Mailing address
225 Oak St
Wind Gap, PA 18091-1638
Phone (610) 863-4604
Other providers in Wind Gap, PA
- St. Luke'S Hospital Bethlehem
- St. Luke'S Hosptial
- St. Luke'S Physician Group Inc
- St. Luke'S Physician Group, Inc.
- St. Luke'S Physician Group, Inc.
- Sarah Elizabeth Stein
- Kenneth P Sun
- Valerie Lynn Szmaciasz
- Donna L Vojtasek
- Beth Anne Votral
All providers in Wind Gap, PA · Athletic Trainer in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.