Provider Demographics
NPI:1043658461
Name:REICHMAN, STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:REICHMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 NESCONSET HWY BLDG 6A
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2552
Mailing Address - Country:US
Mailing Address - Phone:631-751-6666
Mailing Address - Fax:631-751-6681
Practice Address - Street 1:2500 NESCONSET HWY BLDG 6A
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2552
Practice Address - Country:US
Practice Address - Phone:631-751-6666
Practice Address - Fax:631-751-6681
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-07
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038924122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist