Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 1595091 | NY |
N | 2084N0402X | Child Neurologist | MA53786 | NJ |
NPI | 1174504419 |
---|---|
Provider Name | Dr. Steven B Schwartzberg |
First Address | Staten Island, NY 10309-1207 |
Second Address | Staten Island, NY 10304-4310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2005 |
Last Update Date | 24/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01244797 | (05) | NY |
E17632 | (02) |