Provider Demographics
NPI:1043400625
Name:STEPHEN RAND MD
Entity Type:Organization
Organization Name:STEPHEN RAND MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VANDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKAVANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-475-3900
Mailing Address - Street 1:1 E ROE BLVD
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2631
Mailing Address - Country:US
Mailing Address - Phone:631-475-3900
Mailing Address - Fax:631-475-5166
Practice Address - Street 1:1 E ROE BLVD
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2631
Practice Address - Country:US
Practice Address - Phone:631-475-3900
Practice Address - Fax:631-475-5166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty