Healthcare Provider Details

I. General information

NPI: 1720085350
Provider Name (Legal Business Name): KENNETH MICHAEL STEINGLASS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 11/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E 74TH ST APT. PHG
NEW YORK NY
10021-3712
US

IV. Provider business mailing address

300 E 74TH ST APT. PHG
NEW YORK NY
10021-3712
US

V. Phone/Fax

Practice location:
  • Phone: 212-327-4232
  • Fax:
Mailing address:
  • Phone: 212-327-4232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number116908
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number116908
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: