Provider Demographics
NPI:1831148832
Name:WINTER, STEVEN W (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:W
Last Name:WINTER
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 1:110 MARCUS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747
Mailing Address - Country:US
Mailing Address - Phone:631-390-1793
Mailing Address - Fax:631-390-1780
Practice Address - Street 1:110 MARCUS DRIVE
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747
Practice Address - Country:US
Practice Address - Phone:631-390-1793
Practice Address - Fax:631-390-1780
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD422048174400000X
CT043968174400000X
NY183333174400000X
MDD0062210174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY300137705OtherMEDICARE RAILROAD
NY01821943Medicaid
PA087666TSNMedicaid
NYG01309Medicare UPIN
NY621511Medicare PIN
PA087666TSNMedicaid
NY621511Medicare ID - Type Unspecified