Provider Demographics
NPI:1972525350
Name:STEIN, SAMUEL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:JOSEPH
Last Name:STEIN
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 1:51 HURLEY AVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3747
Mailing Address - Country:US
Mailing Address - Phone:845-338-0165
Mailing Address - Fax:845-338-0619
Practice Address - Street 1:51 HURLEY AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3747
Practice Address - Country:US
Practice Address - Phone:845-338-0165
Practice Address - Fax:845-338-0619
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084436174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
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