Provider Demographics
NPI:1588307912
Name:SCHAUPP, STEPHEN (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:SCHAUPP
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 BEDFORD AVE APT 2C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-4476
Mailing Address - Country:US
Mailing Address - Phone:646-535-2232
Mailing Address - Fax:
Practice Address - Street 1:1520 BEDFORD AVE APT 2C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-4476
Practice Address - Country:US
Practice Address - Phone:646-535-2232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG014497225700000X
NY033781225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist