Basic Information
| Provider Information | |||||||||
| NPI: | 1851614515 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEDFORD STUY EMERGENCY PHYSICIANS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 WITMER RD | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | HORSHAM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190442251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154425000 | ||||||||
| FaxNumber: | 2159572875 | ||||||||
| Practice Location | |||||||||
| Address1: | 1545 ATLANTIC AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112131122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186134000 | ||||||||
| FaxNumber: | 2159572875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2010 | ||||||||
| LastUpdateDate: | 03/10/2010 | ||||||||
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| AuthorizedOfficialLastName: | KATZ | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DOCTOR | ||||||||
| AuthorizedOfficialTelephone: | 2154425000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 25MA5001300 | NJ | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.