Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 265749 | NY |
NPI | 1083931497 |
---|---|
Provider Name | Dr. Stephen Maslak |
First Address | Staten Island, NY 10304-2312 |
Second Address | New York, NY 10028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2010 |
Last Update Date | 14/08/2018 |