Provider Demographics
NPI:1073634150
Name:STADLER, ELIZABETH A (PT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:STADLER
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3116 RIVER DRIVE RD
Mailing Address - Street 2:
Mailing Address - City:SPARROWS POINT
Mailing Address - State:MD
Mailing Address - Zip Code:21219-1106
Mailing Address - Country:US
Mailing Address - Phone:443-879-9195
Mailing Address - Fax:
Practice Address - Street 1:8726 TOWN AND COUNTRY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-3061
Practice Address - Country:US
Practice Address - Phone:443-879-9195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22155225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist