Individual
SIOBHAN CATHERINE STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
62 W MAIN ST, BAY SHORE, NY 11706-8314
(631) 665-4560
Mailing address
62 W MAIN ST, BAY SHORE, NY 11706-8314
(516) 830-1818
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
049448
NY
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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