Provider Demographics
NPI:1386607828
Name:HUDYMA, STEVEN (ATC, PTA)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:HUDYMA
Suffix:
Gender:M
Credentials:ATC, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 LAWNTON TER
Mailing Address - Street 2:
Mailing Address - City:HOLMES
Mailing Address - State:PA
Mailing Address - Zip Code:19043-1021
Mailing Address - Country:US
Mailing Address - Phone:610-586-2471
Mailing Address - Fax:
Practice Address - Street 1:196 W SPROUL RD
Practice Address - Street 2:PAV. I SUITE 110
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2045
Practice Address - Country:US
Practice Address - Phone:610-328-8830
Practice Address - Fax:610-328-8981
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART00388882255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer