Healthcare Provider Details

I. General information

NPI: 1770667677
Provider Name (Legal Business Name): JEFFREY S STEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 E 80TH ST SUITE 1E
NEW YORK NY
10075-0117
US

IV. Provider business mailing address

1385 YORK AVE SUITE 3B
NEW YORK NY
10021-3904
US

V. Phone/Fax

Practice location:
  • Phone: 212-396-0500
  • Fax: 866-297-1109
Mailing address:
  • Phone: 212-396-0500
  • Fax: 866-297-1109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number162428
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number162428
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number162428
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: