Basic Information
| Provider Information | |||||||||
| NPI: | 1750305041 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WAXMAN | ||||||||
| FirstName: | STEPHEN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 235 PARK AVE S FL 2 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100031405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126140039 | ||||||||
| FaxNumber: | 2122539631 | ||||||||
| Practice Location | |||||||||
| Address1: | 135 E 37TH ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100163083 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126845061 | ||||||||
| FaxNumber: | 2126794275 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 05/20/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 129487 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.