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General NPI Number Information
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NPI Number | 1245508274
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Entity Type | Individual
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Provider Name | STEVEN ANDREW NUSSBAUM M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/05/2011
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Last Update Date | 05/14/2018
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Provider Practice Location Address
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Address Line | 1438 3RD AVE APT 14E
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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 | 212-717-8744
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Fax |
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Provider Business Mailing Address
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Address Line | 1438 3RD AVE APT 14E
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City | NEW YORK
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State | NY
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Zip | 10028-1964
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Country | US
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Telephone | 212-717-8744
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 187284
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License Number State | NY
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