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General NPI Number Information
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NPI Number | 1083931497
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Entity Type | Individual
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Provider Name | STEPHEN MASLAK M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2010
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Last Update Date | 08/14/2018
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Provider Practice Location Address
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Address Line | NORTHWELL HEALTH PHYSICIAN PARTNERS 178 E 85TH STREET, 4TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10028
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Country | US
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Telephone | 212-434-3427
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Fax | 212-434-3639
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Provider Business Mailing Address
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Address Line | 1408 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2312
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Country | US
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Telephone | 718-979-5646
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 265749
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License Number State | NY
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