Healthcare Provider Details

I. General information

NPI: 1134126188
Provider Name (Legal Business Name): STEVEN BRUCE EPSTEIN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 02/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 W BROADWAY SUITE 10
HEWLETT NY
11557
US

IV. Provider business mailing address

1175 W BROADWAY SUITE 10
HEWLETT NY
11557
US

V. Phone/Fax

Practice location:
  • Phone: 516-374-4444
  • Fax: 516-374-4445
Mailing address:
  • Phone: 516-374-4444
  • Fax: 516-374-4445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberNOO3464-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: