Healthcare Provider Details
I. General information
NPI: 1285942581
Provider Name (Legal Business Name): BARRY D STEIN MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/21/2010
Last Update Date: 09/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
761 MAIN AVE
NORWALK CT
06851-1080
US
IV. Provider business mailing address
12 TERHUNE DR
WESTPORT CT
06880-2707
US
V. Phone/Fax
- Phone: 203-644-1161
- Fax:
- Phone: 908-653-9399
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BARRY
STEIN
Title or Position: OWNER
Credential: MD
Phone: 203-216-0783