MEDICARE: DR. STEVEN SHANE KONRAD 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	2084F0202X	Forensic Psychiatry Physician	248037	NY

General Provider Information

NPI Number	:	1518003318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN SHANE KONRAD M.D.

Provider Business Mailing Address
First Line	:	10 EDWARDS POINT RD
Second Line	:
City	:	RUMSON
State	:	NJ
Zip	:	07760-1215
Country	:	US
Telephone Number	:	443-804-7120
Fax Number	:	844-662-3744

Provider Business Practice Location Address
First Line	:	109 N 12TH ST STE 507
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11249-1002
Country	:	US
Telephone Number	:	443-804-7120
Fax Number	:	844-662-3744

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	08/22/2025

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