Provider Demographics
NPI:1649322926
Name:STEINBERG-MITCHELL, RICKI ELLYN (MD)
Entity type:Individual
Prefix:MRS
First Name:RICKI
Middle Name:ELLYN
Last Name:STEINBERG-MITCHELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 N VILLAGE AVE
Mailing Address - Street 2:SUITE #129
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3761
Mailing Address - Country:US
Mailing Address - Phone:516-678-9600
Mailing Address - Fax:
Practice Address - Street 1:57 W 57TH ST STE 601
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2802
Practice Address - Country:US
Practice Address - Phone:212-586-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171273207K00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133548634OtherTAX ID #
NYE61202Medicare UPIN