Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 262172 | NY |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 262172 | NY |
NPI | 1154527604 |
---|---|
Provider Name | Dr. Stephen S Roberts |
First Address | New York, NY 10065-6007 |
Second Address | New York, NY 10065-6007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2007 |
Last Update Date | 04/08/2011 |