Provider Demographics
NPI:1477085108
Name:STEVEN W PAPPAS, MD
Entity Type:Organization
Organization Name:STEVEN W PAPPAS, MD
Other - Org Name:EASTCHESTER MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:PAPPAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-793-1501
Mailing Address - Street 1:266 WHITE PLAINS RD
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-4429
Mailing Address - Country:US
Mailing Address - Phone:914-793-1115
Mailing Address - Fax:
Practice Address - Street 1:266 WHITE PLAINS RD
Practice Address - Street 2:SUITE 1-A
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-4429
Practice Address - Country:US
Practice Address - Phone:914-793-1115
Practice Address - Fax:914-793-2659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140803261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00952323Medicaid
NYB78923Medicare UPIN