Provider Demographics
NPI:1003167701
Name:STEC MD CLINIC PC
Entity Type:Organization
Organization Name:STEC MD CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-589-7969
Mailing Address - Street 1:619 BRONX RIVER RD
Mailing Address - Street 2:A
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-1703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:31 STRAWBERRY HILL AVE STE 104
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2681
Practice Address - Country:US
Practice Address - Phone:914-589-7969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-21
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT051359261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service