Provider Demographics
NPI:1225715402
Name:MUNIZ, STEVE (MHA)
Entity Type:Individual
Prefix:MR
First Name:STEVE
Middle Name:
Last Name:MUNIZ
Suffix:
Gender:M
Credentials:MHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 BROADWAY APT 51
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-3743
Mailing Address - Country:US
Mailing Address - Phone:917-346-4962
Mailing Address - Fax:
Practice Address - Street 1:3333 HENRY HUDSON PKWY STE 6
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-3224
Practice Address - Country:US
Practice Address - Phone:855-403-2007
Practice Address - Fax:855-403-2023
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33D2282996291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory