Healthcare Provider Details

I. General information

NPI: 1407128077
Provider Name (Legal Business Name): STEINWAY NY MEDICAL ASSOC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3272 STEINWAY ST
ASTORIA NY
11103-4006
US

IV. Provider business mailing address

32-72 STEINWAY STREET
ASTORIA NY
11103-4006
US

V. Phone/Fax

Practice location:
  • Phone: 347-416-1902
  • Fax:
Mailing address:
  • Phone: 347-416-1902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. ELIZABETH MASON
Title or Position: BILLING MANAGER
Credential: CPC
Phone: 347-416-1902