Provider Demographics
NPI:1679563985
Name:CHRISTIANSON, STEVEN WEBSTER (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WEBSTER
Last Name:CHRISTIANSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 SAXON WOODS RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-4813
Mailing Address - Country:US
Mailing Address - Phone:914-949-6113
Mailing Address - Fax:
Practice Address - Street 1:5 PENN PLZ
Practice Address - Street 2:12TH FLOOR, VNS CHOICE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1810
Practice Address - Country:US
Practice Address - Phone:212-609-5614
Practice Address - Fax:212-290-4855
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179894-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E24421Medicare UPIN
838171Medicare ID - Type UnspecifiedMEDICARE PROVIDER #