| Provider / Organization | NPI | Date Certified |
|---|---|---|
| STEPHAN MAYTAWIN HEDDON | 1386366136 | 2022-09-16 |
Stephan Maytawin Heddon is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1386366136. Registration indicates Stephan Maytawin Heddon is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Physical Therapist (Physical Therapist, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| Entity Type | Individual |
| Provider Name | Stephan Maytawin Heddon PT, DPT |
| Practice Office Address | 235 W 75TH ST NEW YORK, NY US |
| Practice Office Telephone | 6465185559 |
| Mailing Address | 307 5TH AVE FL 6 NEW YORK, NY 100166575 US |
| Code | Practice | License No State |
|---|---|---|
| 225100000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist Physical Therapist Speech/Occupational/Physical Therapy/Chiropractor Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | 04891801
NY |