Provider Demographics
NPI:1962122069
Name:KAWAS, STEPHANIE (PT)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:KAWAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7725 WASHINGTON LN APT B
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1038
Mailing Address - Country:US
Mailing Address - Phone:908-601-0534
Mailing Address - Fax:
Practice Address - Street 1:1000 EASTON RD STE 207
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-2900
Practice Address - Country:US
Practice Address - Phone:215-517-7551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02115700225100000X
PAPT030791225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist