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General NPI Number Information
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NPI Number | 1073890810
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Entity Type | Individual
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Provider Name | SCOTT A STEIN D.O.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 4 SMITH HAVEN MALL
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City | LAKE GROVE
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State | NY
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Zip | 11755-1219
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Country | US
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Telephone | 631-444-4630
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Fax |
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Provider Business Mailing Address
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Address Line | 501 W 113TH ST APT 4C
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City | NEW YORK
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State | NY
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Zip | 10025-8073
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 268838
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 268838
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License Number State | NY
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