Basic Information
Provider Information
NPI: 1669823845
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BYRNE
FirstName: STEVEN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 707 E MAIN ST
Address2:  
City: MIDDLETOWN
State: NY
PostalCode: 109402650
CountryCode: US
TelephoneNumber: 8453333370
FaxNumber: 8453333372
Practice Location
Address1: 707 E MAIN ST
Address2:  
City: MIDDLETOWN
State: NY
PostalCode: 109402650
CountryCode: US
TelephoneNumber: 8453333370
FaxNumber: 8453333372
Other Information
ProviderEnumerationDate: 06/28/2016
LastUpdateDate: 07/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X927975005NYN Allopathic & Osteopathic PhysiciansFamily Medicine 
208M00000X301920NYY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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