Provider Demographics
NPI:1649350869
Name:PARRY, STEVEN S (DO)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:S
Last Name:PARRY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 NORTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2322
Mailing Address - Country:US
Mailing Address - Phone:631-724-2233
Mailing Address - Fax:
Practice Address - Street 1:236 NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2322
Practice Address - Country:US
Practice Address - Phone:631-724-2233
Practice Address - Fax:631-724-5170
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182678207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113431078OtherTAX ID #
NY182678OtherLICENSE #
NY04G381Medicare PIN
NY182678OtherLICENSE #