MEDICARE: STEVEN PAUL WALDMAN 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	174400000X	Specialist	25MA07732700	NJ
2	174400000X	Specialist	1587191	NY

General Provider Information

NPI Number	:	1861416364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN PAUL WALDMAN M.D.

Provider Business Mailing Address
First Line	:	81 KINGSWOOD RD
Second Line	:
City	:	WEEHAWKEN
State	:	NJ
Zip	:	07086-6908
Country	:	US
Telephone Number	:	201-430-2022
Fax Number	:	201-243-7261

Provider Business Practice Location Address
First Line	:	8901 KENNEDY BLVD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-5344
Country	:	US
Telephone Number	:	201-430-2022
Fax Number	:	201-243-7261

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	09/28/2015

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