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General NPI Number Information
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NPI Number | 1265420749
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Entity Type | Individual
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Provider Name | STEPHEN PETER RAND MD
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Gender | Male
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 2270 KIMBALL ST STW 206
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City | BROOKLYN
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State | NY
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Zip | 11234-5139
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Country | US
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Telephone | 718-377-0011
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Fax | 718-377-0011
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Provider Business Mailing Address
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Address Line | 80 MARCUS DR PROVIDER ENROLLMENT
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City | MELVILLE
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State | NY
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Zip | 11747-4230
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Country | US
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Telephone | 631-391-7887
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Fax | 631-454-4163
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 114186
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 114186
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License Number State | NY
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