Provider Demographics
NPI: | 1881906873 |
---|---|
Name: | JONATHAN R. STIEBER, MD, PLLC |
Entity type: | Organization |
Organization Name: | JONATHAN R. STIEBER, MD, PLLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JONATHAN |
Authorized Official - Middle Name: | R |
Authorized Official - Last Name: | STIEBER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 212-883-8868 |
Mailing Address - Street 1: | 485 MADISON AVE FL 8 |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10022-5803 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 212-883-8868 |
Mailing Address - Fax: | 212-883-8886 |
Practice Address - Street 1: | 485 MADISON AVE FL 8 |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10022-5803 |
Practice Address - Country: | US |
Practice Address - Phone: | 212-883-8868 |
Practice Address - Fax: | 212-883-8886 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-07-08 |
Last Update Date: | 2018-11-30 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207XS0117X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine | Group - Single Specialty |