Basic Information
Provider Information
NPI: 1588206288
EntityType: 2
ReplacementNPI:  
OrganizationName: SUZANNE R STEINBAUM DO PC
LastName:  
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Mailing Information
Address1: 800 5TH AVE STE 205
Address2:  
City: NEW YORK
State: NY
PostalCode: 100657216
CountryCode: US
TelephoneNumber: 2127583200
FaxNumber:  
Practice Location
Address1: 800 5TH AVE STE 205
Address2:  
City: NEW YORK
State: NY
PostalCode: 100657216
CountryCode: US
TelephoneNumber: 2127583200
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/14/2019
LastUpdateDate: 10/14/2019
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: STEINBAUM
AuthorizedOfficialFirstName: SUZANNE
AuthorizedOfficialMiddleName: R
AuthorizedOfficialTitleorPosition: DO, OWNER
AuthorizedOfficialTelephone: 2127583200
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: DO
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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