Provider Demographics
NPI:1235214339
Name:HUISH, STEPHEN HENRY (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:HENRY
Last Name:HUISH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4507
Mailing Address - Country:US
Mailing Address - Phone:718-409-0050
Mailing Address - Fax:718-409-6955
Practice Address - Street 1:3225 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-4507
Practice Address - Country:US
Practice Address - Phone:718-409-0050
Practice Address - Fax:718-409-6955
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198359208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY212682Medicare ID - Type Unspecified
NYG36813Medicare UPIN