Provider Demographics
NPI:1720152366
Name:STIBER, ANDREW J (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:STIBER
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 1:220 EAST 30 STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8202
Mailing Address - Country:US
Mailing Address - Phone:212-686-0499
Mailing Address - Fax:212-779-4648
Practice Address - Street 1:220 EAST 30 STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8202
Practice Address - Country:US
Practice Address - Phone:212-686-0499
Practice Address - Fax:212-779-4648
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY096846207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B16632Medicare UPIN
56833Medicare ID - Type Unspecified