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Organization
LEE STAEBLER PT PC
Active
Organization
LEE STAEBLER PT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEE B STAEBLER DPT (PRESIDENT/OWNER)
(631) 298-8859
Entity
Organization
Contact information
Practice address
7555 MAIN RD, MATTITUCK, NY 11952-1516
(631) 298-8859
(631) 298-8119
Mailing address
PO BOX 206, MATTITUCK, NY 11952-0206
(631) 298-8859
(631) 298-8119
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0102401
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01905426
—
NY
01
—
DF8222
RAILROAD MEDICARE
NY
01
—
QN6271
EMPIRE BC/BS
NY
Enumeration date
10/04/2007
Last updated
11/07/2007
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