Healthcare Provider Details

I. General information

NPI: 1922184878
Provider Name (Legal Business Name): RUTH E STEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 MORRIS PARK AVE
BRONX NY
10461-1929
US

IV. Provider business mailing address

91 LARCHMONT AVE
LARCHMONT NY
10538-3748
US

V. Phone/Fax

Practice location:
  • Phone: 718-839-7057
  • Fax:
Mailing address:
  • Phone: 718-741-2500
  • Fax: 718-405-5609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number099501
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number099501
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: