Provider Demographics
NPI:1295799625
Name:MCCLAIN, STEVE A (MD,)
Entity type:Individual
Prefix:DR
First Name:STEVE
Middle Name:A
Last Name:MCCLAIN
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 1:45 MANOR RD
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2735
Mailing Address - Country:US
Mailing Address - Phone:631-361-4000
Mailing Address - Fax:631-361-4037
Practice Address - Street 1:45 MANOR RD
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2735
Practice Address - Country:US
Practice Address - Phone:631-361-4000
Practice Address - Fax:631-361-4037
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-13
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163196207ZD0900X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01467243Medicaid
NY163196OtherNY MEDICAL LICENSE#
D33805Medicare UPIN