Basic Information
Provider Information
NPI: 1245520832
EntityType: 2
ReplacementNPI:  
OrganizationName: STEVE SHAY LLC
LastName:  
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Credential:  
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Mailing Information
Address1: PO BOX 270
Address2:  
City: MASSAPEQUA PARK
State: NY
PostalCode: 117620270
CountryCode: US
TelephoneNumber: 6312642035
FaxNumber: 6312641418
Practice Location
Address1: 1129 NORTHERN BLVD
Address2: SUITE 409
City: MANHASSET
State: NY
PostalCode: 110303022
CountryCode: US
TelephoneNumber: 5163657475
FaxNumber: 5166273057
Other Information
ProviderEnumerationDate: 04/15/2011
LastUpdateDate: 04/15/2011
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: SHAY
AuthorizedOfficialFirstName: STEVE
AuthorizedOfficialMiddleName: XIANG-HU
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 9176766954
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X200241NYY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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