Provider Demographics
NPI:1063134724
Name:STEADFAST PHYSICAL THERAPY P.C.
Entity type:Organization
Organization Name:STEADFAST PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:VEDAD
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:929-329-6600
Mailing Address - Street 1:20214 ROCKY HILL RD APT J1
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3050
Mailing Address - Country:US
Mailing Address - Phone:929-329-6600
Mailing Address - Fax:631-913-1337
Practice Address - Street 1:8 MAPLE ST STE 9
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-2963
Practice Address - Country:US
Practice Address - Phone:929-329-6600
Practice Address - Fax:631-913-1337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-19
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty