Provider Demographics
NPI:1952328718
Name:SHTAINER, ALFRED (MD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:
Last Name:SHTAINER
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 1:24 E 12 ST
Mailing Address - Street 2:#2 1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-243-5300
Mailing Address - Fax:212-924-8870
Practice Address - Street 1:24 E 12 ST
Practice Address - Street 2:#2 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-243-5300
Practice Address - Fax:212-924-8870
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1789381208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01422839Medicaid
NY68H161Medicare ID - Type Unspecified
NY01422839Medicaid
NY68H162Medicare ID - Type UnspecifiedBROOKLYN