Provider Demographics
NPI:1104837806
Name:STONE, AARON LEIB (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:LEIB
Last Name:STONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ALAN
Other - Middle Name:LESLIE
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1474 CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-4514
Mailing Address - Country:US
Mailing Address - Phone:718-613-0642
Mailing Address - Fax:718-953-5049
Practice Address - Street 1:1474 CARROLL ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4514
Practice Address - Country:US
Practice Address - Phone:718-613-0642
Practice Address - Fax:718-953-5049
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182040207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01337104Medicaid
20I002OtherMEDICARE
20I001Medicare ID - Type Unspecified
E52798Medicare UPIN