Provider Demographics
NPI:1679772636
Name:STIEBER, JONATHAN ROSS (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:ROSS
Last Name:STIEBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:485 MADISON AVE
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5822
Mailing Address - Country:US
Mailing Address - Phone:212-883-8868
Mailing Address - Fax:212-883-8886
Practice Address - Street 1:485 MADISON AVE
Practice Address - Street 2:FL 8
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5822
Practice Address - Country:US
Practice Address - Phone:212-883-8868
Practice Address - Fax:212-883-8886
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY239623-01207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY63132TW631Medicare PIN