Provider Demographics
NPI:1972909430
Name:PAGEL, STEVEN (LMT, CMMP)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:PAGEL
Suffix:
Gender:M
Credentials:LMT, CMMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3922 PINE ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4102
Mailing Address - Country:US
Mailing Address - Phone:215-431-5292
Mailing Address - Fax:
Practice Address - Street 1:3922 PINE ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4102
Practice Address - Country:US
Practice Address - Phone:215-431-5292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG009616225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist