Healthcare Provider Details

I. General information

NPI: 1215924618
Provider Name (Legal Business Name): JULIAN M STEWART MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 01/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRADHURST AVE SUITE 1400
HAWTHORNE NY
10532-2140
US

IV. Provider business mailing address

19 BRADHURST AVE STE 1400
HAWTHORNE NY
10532-2140
US

V. Phone/Fax

Practice location:
  • Phone: 914-594-4370
  • Fax: 914-594-4513
Mailing address:
  • Phone: 914-594-4370
  • Fax: 914-594-4513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number136837
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: