Healthcare Provider Details

I. General information

NPI: 1174951602
Provider Name (Legal Business Name): ALEX SHTEYNSHLYUGER MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2013
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 W 46TH ST FL 5
NEW YORK NY
10036-4103
US

IV. Provider business mailing address

33 W 46TH ST FL 5
NEW YORK NY
10036-4103
US

V. Phone/Fax

Practice location:
  • Phone: 646-663-5252
  • Fax: 718-285-8555
Mailing address:
  • Phone: 646-663-5252
  • Fax: 718-285-8555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number250902
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALEX SHTEYNSHLYUGER
Title or Position: CEO
Credential: MD
Phone: 646-663-5252