Provider Demographics
NPI:1629058011
Name:RADOWITZ, STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:RADOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568 BROADWAY RM 303
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-3271
Mailing Address - Country:US
Mailing Address - Phone:646-849-5151
Mailing Address - Fax:212-874-4690
Practice Address - Street 1:568 BROADWAY RM 303
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3271
Practice Address - Country:US
Practice Address - Phone:646-849-5151
Practice Address - Fax:212-874-4690
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226877207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY59N571Medicare PIN
NYG80864Medicare UPIN