Provider Demographics
NPI:1912920281
Name:TAY, STEVEN IRA (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:IRA
Last Name:TAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:IRA
Other - Last Name:TAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 95000-5590
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:95000-5590
Mailing Address - Country:US
Mailing Address - Phone:212-253-6800
Mailing Address - Fax:212-253-2190
Practice Address - Street 1:10 UNION SQ EAST
Practice Address - Street 2:SUITE 5-M
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-253-9322
Practice Address - Fax:212-253-2190
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY127121207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
575126Medicare UPIN
31225A1Medicare ID - Type Unspecified