Provider Demographics
NPI:1629312061
Name:STEIN, ROBERT BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BENJAMIN
Last Name:STEIN
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 1:155 OCEANA DR E
Mailing Address - Street 2:SUITE 4I
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6996
Mailing Address - Country:US
Mailing Address - Phone:650-283-5834
Mailing Address - Fax:650-249-0460
Practice Address - Street 1:155 OCEANA DR E
Practice Address - Street 2:SUITE 4I
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6996
Practice Address - Country:US
Practice Address - Phone:650-283-5834
Practice Address - Fax:650-249-0460
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266883174400000X
PAMD051742L174400000X
NC25834174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist