Healthcare Provider Details

I. General information

NPI: 1821084948
Provider Name (Legal Business Name): STEVE SANG HAHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 BRIARCLIFF RD
STATEN ISLAND NY
10305-2620
US

IV. Provider business mailing address

75 BRIARCLIFF RD
STATEN ISLAND NY
10305-2620
US

V. Phone/Fax

Practice location:
  • Phone: 718-981-1903
  • Fax: 718-981-1903
Mailing address:
  • Phone: 718-981-1903
  • Fax: 718-981-1903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number151423
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: