Basic Information
| Provider Information | |||||||||
| NPI: | 1003280645 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEINKRAUS | ||||||||
| FirstName: | PHILLIP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2142 UTOPIA PKWY | ||||||||
| Address2: | |||||||||
| City: | WHITESTONE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113574142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188196805 | ||||||||
| FaxNumber: | 3478419109 | ||||||||
| Practice Location | |||||||||
| Address1: | 92 BROADWAY | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | GREENLAWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117401328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312627855 | ||||||||
| FaxNumber: | 6312627854 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/19/2015 | ||||||||
| LastUpdateDate: | 06/28/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 039690 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.