Provider Demographics
NPI:1942264577
Name:HOFSTETTER, STEVEN R (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:HOFSTETTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:330 E 38TH ST
Mailing Address - Street 2:33N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2759
Mailing Address - Country:US
Mailing Address - Phone:212-697-0475
Mailing Address - Fax:
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:6C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-7302
Practice Address - Fax:212-263-7511
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY112669208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00306318Medicaid
NY00306318Medicaid
NY569021Medicare PIN