Altair Robert Stephens
Specialist/Technologist, Athletic Trainer in Jamaica, NY. Individual provider (NPI-1).
NPI number1538769500
StatusActive
Last updated in NPPESOct 29, 2020
Details
- NPI
- 1538769500
- Entity type
- Individual (NPI-1)
- Name
- Altair Robert Stephens
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 29, 2020
- Certification date
- Oct 29, 2020
- Last updated
- Oct 29, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
22004 Linden BlvdJamaica, NY 11411-1621
Phone 718-712-3358
Mailing address
22004 Linden BlvdJamaica, NY 11411-1621
Phone 718-712-3358
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