Healthcare Provider Details

I. General information

NPI: 1629466172
Provider Name (Legal Business Name): STEUBEN OPERATIONS ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2015
Last Update Date: 02/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7009 RUMSEY STREET EXT
BATH NY
14810-7827
US

IV. Provider business mailing address

4770 WHITE PLAINS RD
BRONX NY
10470-1104
US

V. Phone/Fax

Practice location:
  • Phone: 607-776-7651
  • Fax:
Mailing address:
  • Phone: 718-931-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. KENNETH ROZENBERG
Title or Position: MEMBER
Credential:
Phone: 718-931-9700