Basic Information
| Provider Information | |||||||||
| NPI: | 1508491879 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MARJORIE STEIN, M.D., PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5106 VERNON BLVD | ||||||||
| Address2: | STE 201 | ||||||||
| City: | LONG ISLAND CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5168440334 | ||||||||
| FaxNumber: | 8778887955 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 COACH LANE | ||||||||
| Address2: | |||||||||
| City: | MUTTONTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11791 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5168440334 | ||||||||
| FaxNumber: | 8778887955 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2020 | ||||||||
| LastUpdateDate: | 03/07/2020 | ||||||||
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| AuthorizedOfficialLastName: | STEIN | ||||||||
| AuthorizedOfficialFirstName: | MARJORIE | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5168440334 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 03/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 2085R0202X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.