Healthcare Provider Details

I. General information

NPI: 1962587030
Provider Name (Legal Business Name): STEVE E NOZAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2513 EAST 12TH STREET
BKLYN NY
11235
US

IV. Provider business mailing address

2513 EAST 12TH STREET
BKLYN NY
11235
US

V. Phone/Fax

Practice location:
  • Phone: 718-332-5009
  • Fax: 718-332-5690
Mailing address:
  • Phone: 718-332-5009
  • Fax: 718-332-5690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number148878
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: