Healthcare Provider Details

I. General information

NPI: 1942686555
Provider Name (Legal Business Name): NOAH DAVID STEIN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2015
Last Update Date: 11/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL RD STE 112
EAST PATCHOGUE NY
11772-8811
US

IV. Provider business mailing address

1 FOXHILL LN
STONY BROOK NY
11790-1230
US

V. Phone/Fax

Practice location:
  • Phone: 631-456-5512
  • Fax: 631-456-5514
Mailing address:
  • Phone: 585-738-1383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: