Provider Demographics
NPI:1720248842
Name:HOLT, STEPHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:HOLT
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 1:12 E 52ND ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5312
Mailing Address - Country:US
Mailing Address - Phone:973-256-4660
Mailing Address - Fax:973-256-8085
Practice Address - Street 1:12 E 52ND ST
Practice Address - Street 2:SUITE 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5312
Practice Address - Country:US
Practice Address - Phone:973-256-4660
Practice Address - Fax:973-256-8085
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194529173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine