Basic Information
| Provider Information | |||||||||
| NPI: | 1629466172 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEUBEN OPERATIONS ASSOCIATES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4770 WHITE PLAINS RD | ||||||||
| Address2: | |||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104701104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189319700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7009 RUMSEY STREET EXT | ||||||||
| Address2: | |||||||||
| City: | BATH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 148107827 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077767651 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2015 | ||||||||
| LastUpdateDate: | 02/19/2017 | ||||||||
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| AuthorizedOfficialLastName: | ROZENBERG | ||||||||
| AuthorizedOfficialFirstName: | KENNETH | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 7189319700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | N | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.