Healthcare Provider Details

I. General information

NPI: 1053316836
Provider Name (Legal Business Name): DAVID M.S. SHEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 01/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 WATERS PL SUITE 903
BRONX NY
10461-2720
US

IV. Provider business mailing address

1250 WATERS PL SUITE 903
BRONX NY
10461-2720
US

V. Phone/Fax

Practice location:
  • Phone: 718-450-9955
  • Fax: 718-450-9988
Mailing address:
  • Phone: 718-450-9955
  • Fax: 718-450-9988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number195110
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number195110
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: