Provider Demographics
NPI:1831273507
Name:LOWY, STANLEY T (MD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:T
Last Name:LOWY
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 1:231 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4236
Mailing Address - Country:US
Mailing Address - Phone:917-292-7467
Mailing Address - Fax:
Practice Address - Street 1:231 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4236
Practice Address - Country:US
Practice Address - Phone:917-292-7467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY193533207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01501037Medicaid
NY554ACQMedicare ID - Type UnspecifiedGHI MEDICARE
NY01501037Medicaid