Healthcare Provider Details

I. General information

NPI: 1104124775
Provider Name (Legal Business Name): SHOTEN & LIBERMAN,M.D.S PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2011
Last Update Date: 03/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

182 W MONTAUK HWY STE H
HAMPTON BAYS NY
11946-2395
US

IV. Provider business mailing address

182 W MONTAUK HWY STE H
HAMPTON BAYS NY
11946-2395
US

V. Phone/Fax

Practice location:
  • Phone: 631-723-0022
  • Fax: 631-723-3304
Mailing address:
  • Phone: 631-723-0022
  • Fax: 631-723-3304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN SHOTEN
Title or Position: OWNER
Credential:
Phone: 631-723-0022