MEDICARE: STEVEN GRUENSTEIN 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	207RH0003X	Hematology & Oncology Physician	1776051	NY

General Provider Information

NPI Number	:	1407855307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN GRUENSTEIN M.D.

Provider Business Mailing Address
First Line	:	1500 ROUTE 112 BLDG 4
Second Line	:
City	:	PORT JEFFERSON STATION
State	:	NY
Zip	:	11776-8055
Country	:	US
Telephone Number	:	631-751-3000
Fax Number	:	631-509-6559

Provider Business Practice Location Address
First Line	:	12 E 86TH ST OFC 4
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-0517
Country	:	US
Telephone Number	:	212-861-6660
Fax Number	:	212-744-4696

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	01/17/2020

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