Provider Demographics
NPI:1578580585
Name:SHTEERMAN, EUGENE (MD, FACC)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:
Last Name:SHTEERMAN
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1384 EAST 19 STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230
Mailing Address - Country:US
Mailing Address - Phone:718-336-3033
Mailing Address - Fax:718-336-3006
Practice Address - Street 1:1384 E 19TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6112
Practice Address - Country:US
Practice Address - Phone:718-336-3033
Practice Address - Fax:718-336-3006
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219418174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI01398Medicare UPIN