Provider Demographics
NPI:1740290105
Name:SIEGEL, STEPHEN DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:DAVID
Last Name:SIEGEL
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 1:3 E 71ST ST
Mailing Address - Street 2:1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4154
Mailing Address - Country:US
Mailing Address - Phone:212-879-8000
Mailing Address - Fax:212-288-5961
Practice Address - Street 1:3 E 71ST ST
Practice Address - Street 2:1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4154
Practice Address - Country:US
Practice Address - Phone:212-879-8000
Practice Address - Fax:212-288-5961
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161427207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61353Medicare UPIN
22E801Medicare ID - Type Unspecified