Provider Demographics
NPI:1881688646
Name:KRIGSMAN, STEPHEN M (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:KRIGSMAN
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 1:143 N LONG BEACH RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4438
Mailing Address - Country:US
Mailing Address - Phone:516-678-2093
Mailing Address - Fax:516-678-9172
Practice Address - Street 1:143 N LONG BEACH RD
Practice Address - Street 2:SUITE 4
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-4438
Practice Address - Country:US
Practice Address - Phone:516-678-2093
Practice Address - Fax:516-678-9172
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYMD103713207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology