Doctor Name: | DR. STACY MICHELLE JAFFEE GROPACK |
NPI Number: | 1083044093 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT, PHD |
License Number: | 008975 |
Business Practice Address: | 397 Frankel Blvd Merrick, NY - 115665035 |
Business Phone Number: | 5164191347 |
Business Fax Number: | |
Mailing Address: | 397 Frankel Blvd, MERRICK |
State: | NY |
Postal Code: | 115665035 |
Phone Number: | 5164191347 |
Fax Number: | |
NPI Enumeration Date: | 11/13/2013 |
NPI Last Update Date: | 11/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | 008975 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |