Stuart S Basom, P.T.
Individual provider Active NPI Physical Therapist · Lemoyne, PA
NPI 1790783082 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1790783082
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT001970E (PA)
- Practice address
- 550 N 12TH St
Suite 120
Lemoyne, PA 17043-1213 - Phone
- (717) 737-9818
- Fax
- (717) 737-2815
- NPI assigned
- Jul 11, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT001970E | PA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McCuen & Associates Physical Therapy, P.C. | Physical Therapist | Past |
Accepting new patients |
| McCuen & Associates Physical Therapy, PC | Physical Therapist | Past | Accepting new patients |
| Douglas Avery and Associates LTD | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT001970E | PA | Yes |
Addresses
Primary practice location
550 N 12TH St
Suite 120
Lemoyne, PA 17043-1213
Mailing address
550 N 12TH St
Suite 120
Lemoyne, PA 17043-1242
Phone (717) 737-9818
Other providers in Lemoyne, PA
- Carrie Dietz Banton
- Keila Barbour
- Jennifer Barimah
- Scott Grey Barnes
- Ronald G Barsanti
- Laura Marlene Bates
- Bayada Home Health Care, Inc.
- Be Present Counseling LLC
- Rommel Bebe
- Becker Chiropractic Center, P.C.
All providers in Lemoyne, PA · Physical Therapist 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.