Provider Demographics
NPI:1750312955
Name:THAU, STEVEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:THAU
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 1:1505 POST RD E STE 101
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5512
Mailing Address - Country:US
Mailing Address - Phone:203-221-3370
Mailing Address - Fax:203-221-3380
Practice Address - Street 1:1505 POST RD E STE 100
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5512
Practice Address - Country:US
Practice Address - Phone:203-221-3370
Practice Address - Fax:203-221-3380
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288762207RP1001X
CT038716207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001387168Medicaid
H15765Medicare UPIN
290000323Medicare ID - Type Unspecified