MEDICARE: DR. STUART LARRY SAFTCHICK II M.D.

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	207R00000X	Internal Medicine Physician	165660-1	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	:	1194731950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STUART LARRY SAFTCHICK II M.D.

Provider Business Mailing Address
First Line	:	PO BOX 20585
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-0071
Country	:	US
Telephone Number	:	212-779-4848
Fax Number	:	212-779-3377

Provider Business Practice Location Address
First Line	:	1387 CASTLE HILL AVE
Second Line	:	SUITE 6
City	:	BRONX
State	:	NY
Zip	:	10462-4833
Country	:	US
Telephone Number	:	718-931-4200
Fax Number	:	718-931-8869

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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