Healthcare Provider Details

I. General information

NPI: 1427108554
Provider Name (Legal Business Name): STEVEN RISMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CLARA MAASS DR CLARA MAASS MEDICAL CENTER
BELLEVILLE NJ
07109-3550
US

IV. Provider business mailing address

PO BOX 717
LIVINGSTON NJ
07039-0717
US

V. Phone/Fax

Practice location:
  • Phone: 973-450-2000
  • Fax:
Mailing address:
  • Phone: 800-345-0064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MA06974100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: