Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 273589 | NY |
N | 111NI0900X | Internist | 273589 | NY |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 273589 | NY |
N | 207RC0000X | Internist - Cardiovascular Disease | 273589 | NY |
NPI | 1952581779 |
---|---|
Provider Name | Dr. Stephen Pan |
First Address | Valhalla, NY 10595-1530 |
Second Address | Valhalla, NY 10595-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2007 |
Last Update Date | 18/11/2021 |