Active NPI
Eric Stefanik, PTA
- Physical Therapy Assistant
- New Bedford, MA
National Provider Identifier
1780109884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 9393
- Practice address
- 863 Hathaway Rd
New Bedford, MA 02740-1916 - Phone
- (508) 966-6763
- NPI assigned
- Aug 9, 2017
- 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 Therapy Assistant | 225200000X | 9393 | MA | Primary |
Addresses
Primary practice location
863 Hathaway Rd
New Bedford, MA 02740-1916
Mailing address
251 Clews St
Pawtucket, RI 02861-1478
Phone (401) 617-0231
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 |
|---|---|---|---|
| 9393 | MA | MD | Hand Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502236800000",
"number": "1780109884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "251 CLEWS ST",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028611478",
"telephone_number": "401-617-0231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "863 HATHAWAY RD",
"city": "NEW BEDFORD",
"state": "MA",
"postal_code": "027401916",
"telephone_number": "508-966-6763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEFANIK",
"first_name": "ERIC",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-09",
"last_updated": "2017-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "9393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Bedford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.