Basic Information
| Provider Information | |||||||||
| NPI: | 1508119678 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STABILE | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | JOHN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 210 E 86TH ST | ||||||||
| Address2: | RM 502 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100287725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162383314 | ||||||||
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| Practice Location | |||||||||
| Address1: | 210 E 86TH ST | ||||||||
| Address2: | SUITE 502 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100283003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122490904 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2012 | ||||||||
| LastUpdateDate: | 04/17/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 016721 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.