Basic Information
Provider Information | |||||||||
NPI: | 1306914064 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | STEINWAY MEDICAL ASSOCIATES, P.C. | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 3117 41ST ST | ||||||||
Address2: |   | ||||||||
City: | ASTORIA | ||||||||
State: | NY | ||||||||
PostalCode: | 111033901 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7182785100 | ||||||||
FaxNumber: | 7182786757 | ||||||||
Practice Location | |||||||||
Address1: | 3117 41ST ST | ||||||||
Address2: |   | ||||||||
City: | ASTORIA | ||||||||
State: | NY | ||||||||
PostalCode: | 111033901 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7182785100 | ||||||||
FaxNumber: | 7182786757 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 12/01/2006 | ||||||||
LastUpdateDate: | 03/21/2016 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | OO | ||||||||
AuthorizedOfficialFirstName: | ZAW | ||||||||
AuthorizedOfficialMiddleName: | MIN | ||||||||
AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
AuthorizedOfficialTelephone: | 7182785100 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | M.D | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 214914 | NY | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |   | 207RC0000X | 136246 | NY | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RN0300X | 205570 | NY | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 2084P0800X | 230776 | NY | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 207R00000X | 198749 | NY | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |   |
ID Information
ID | Type | State | Issuer | Description | 01843681 | 05 | NY |   | MEDICAID | 02678706 | 05 | NY |   | MEDICAID | 01369795 | 05 | NY |   | MEDICAID | 01616673 | 05 | NY |   | MEDICAID | 01501555 | 05 | NY |   | MEDICAID |