Provider Demographics
NPI:1689758567
Name:LOSIK, STEVE BOLESLAV (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:BOLESLAV
Last Name:LOSIK
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 1:6325 SAUNDERS DRIVE
Mailing Address - Street 2:APT 4G
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374
Mailing Address - Country:US
Mailing Address - Phone:917-432-8668
Mailing Address - Fax:
Practice Address - Street 1:3049 OCEAN PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8395
Practice Address - Country:US
Practice Address - Phone:718-265-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2263202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H81240Medicare UPIN