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Organization

AQUATIC THERAPY OF CHINATOWN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LEONARD STAVROPOLSKIY MD (PHYSICAL THERAPY/OWNER)
(215) 574-9388
Entity
Organization

Contact information

Practice address
933 SPRING ST, PHILADELPHIA, PA 19107-1815
(215) 574-9388
(215) 574-9188
Mailing address
7300 BRUCE DRIVE, HOLLAND, PA 18966
(215) 703-3275

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT015799
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2155332000
KEYSTONE HEALTH PLAN EAST
PA
Enumeration date
06/28/2006
Last updated
08/22/2020
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