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General NPI Number Information
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NPI Number | 1699154039
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Entity Type | Organization
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Legal Business Name | SAMUEL J. STEIN M.D.
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Dates
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Enumeration Date | 05/19/2015
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Last Update Date | 05/19/2015
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Provider Practice Location Address
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Address Line | 51 HURLEY AVE SUITE 3
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City | KINGSTON
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State | NY
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Zip | 12401-3747
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Country | US
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Telephone | 845-338-0165
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Fax | 845-338-0619
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Provider Business Mailing Address
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Address Line | 51 HURLEY AVE SUITE 3
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City | KINGSTON
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State | NY
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Zip | 12401-3747
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Country | US
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Telephone | 845-338-0165
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Fax | 845-338-0619
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SAMUEL J STEIN
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Credential | M.D.
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Telephone | 845-338-0165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 084436
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License Number State | NY
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