Provider Demographics
NPI:1487847869
Name:STEPHEN T BRAUN DO PLLC
Entity Type:Organization
Organization Name:STEPHEN T BRAUN DO PLLC
Other - Org Name:SOUTHAMPTON OSTEOPATHY/HEALING OSTEOPATHIC TOUCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:BRAUN DO PLLC
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-377-3630
Mailing Address - Street 1:349 MEETING HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-5051
Mailing Address - Country:US
Mailing Address - Phone:631-377-3630
Mailing Address - Fax:
Practice Address - Street 1:349 MEETING HOUSE LN
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-5051
Practice Address - Country:US
Practice Address - Phone:631-377-3630
Practice Address - Fax:631-377-3631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208224207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWCW911Medicare PIN