Provider Demographics
NPI:1477623379
Name:STEFFENS, ADAM SCOTT (LPN)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:SCOTT
Last Name:STEFFENS
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-1649
Mailing Address - Country:US
Mailing Address - Phone:631-580-1354
Mailing Address - Fax:
Practice Address - Street 1:546 PARK AVE
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-1649
Practice Address - Country:US
Practice Address - Phone:631-580-1354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286309164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse