Provider Demographics
NPI:1083931497
Name:MASLAK, STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:MASLAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2312
Mailing Address - Country:US
Mailing Address - Phone:718-979-5646
Mailing Address - Fax:
Practice Address - Street 1:NORTHWELL HEALTH PHYSICIAN PARTNERS
Practice Address - Street 2:178 E 85TH STREET, 4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028
Practice Address - Country:US
Practice Address - Phone:212-434-3427
Practice Address - Fax:212-434-3639
Is Sole Proprietor?:No
Enumeration Date:2010-04-24
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY265749207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease