Provider Demographics
NPI:1992425722
Name:STALDER, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:STALDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2448 TUCKER RD
Mailing Address - Street 2:
Mailing Address - City:NEW WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:13122-8607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1630 CAMPUS PARK DR STE D
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5270
Practice Address - Country:US
Practice Address - Phone:704-283-9422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049147225100000X
FL41244225100000X
NCP23311225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist