Healthcare Provider Details

I. General information

NPI: 1063562759
Provider Name (Legal Business Name): STEPHEN ARTHUR LUND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 03/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 W 55TH ST 4TH FLOOR
NEW YORK NY
10019-4460
US

IV. Provider business mailing address

200 RIVERSIDE BLVD APARTMENT 18J
NEW YORK NY
10069-0901
US

V. Phone/Fax

Practice location:
  • Phone: 212-994-4570
  • Fax:
Mailing address:
  • Phone: 917-441-9817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number190184
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: