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General NPI Number Information
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NPI Number | 1922099852
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Entity Type | Individual
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Provider Name | STUART WASSER MD
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Gender | Male
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 176 N. VILLAGE AVENUE SUITE 2E
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570
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Country | US
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Telephone | 516-594-2514
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Fax | 516-208-5510
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Provider Business Mailing Address
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Address Line | 176 N VILLAGE AVE STE 2E
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-3800
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Country | US
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Telephone | 516-594-2514
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Fax | 516-208-5510
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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 | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | 173354
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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 | 173354
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License Number State | NY
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