Basic Information
Provider Information
NPI: 1124313325
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OVEN
FirstName: STEVEN
MiddleName: D
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2450 W HUNTING PARK AVE
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191291302
CountryCode: US
TelephoneNumber: 2157286900
FaxNumber: 2157285507
Practice Location
Address1: 150 55TH ST
Address2: LUTHERAN MEDICAL CENTER DEPARTMENT OF SURGERY
City: BROOKLYN
State: NY
PostalCode: 11220
CountryCode: US
TelephoneNumber: 7186307351
FaxNumber: 7186308471
Other Information
ProviderEnumerationDate: 06/15/2011
LastUpdateDate: 03/17/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/17/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208200000XOS017774PAY Allopathic & Osteopathic PhysiciansPlastic Surgery 

No ID Information.


Home