MEDICARE: STEVEN L PRINCE D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	N004623	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013980630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN L PRINCE D.P.M.

Provider Business Mailing Address
First Line	:	78 MARINA RD
Second Line	:
City	:	ISLAND PARK
State	:	NY
Zip	:	11558-1007
Country	:	US
Telephone Number	:	516-432-1332
Fax Number	:

Provider Business Practice Location Address
First Line	:	78 MARINA RD
Second Line	:
City	:	ISLAND PARK
State	:	NY
Zip	:	11558-1007
Country	:	US
Telephone Number	:	516-432-1332
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	07/22/2009

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