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NPI Code Detail

MEDICARE: DR. STEPHEN JOSEPH MASSIMI M.D.

MEDICARE: DR. STEPHEN JOSEPH MASSIMI 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
1208100000XPhysical Medicine & Rehabilitation Physician255564NY
22081S0010XSports Medicine (Physical Medicine & Rehabilitation) Physician255564NY
3208100000XPhysical Medicine & Rehabilitation Physician52074CT

General Provider Information

NPI Number : 1831331388
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN JOSEPH MASSIMI M.D.
Provider Business Mailing Address
First Line : PO BOX 626
Second Line :
City : GREAT RIVER
State : NY
Zip : 11739-0626
Country : US
Telephone Number : 203-705-2350
Fax Number : 203-705-2924
Provider Business Practice Location Address
First Line : 1 BLACHLEY RD
Second Line : HOSPITAL FOR SPECIAL SURGERY
City : STAMFORD
State : CT
Zip : 06902-0002
Country : US
Telephone Number : 203-705-2350
Fax Number : 203-705-2924
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2009
Last Update Date : 11/01/2024

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