Provider Demographics
NPI:1174530570
Name:STEIN, JOSEPH ISAAC (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ISAAC
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 16TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-1431
Mailing Address - Country:US
Mailing Address - Phone:718-851-2663
Mailing Address - Fax:
Practice Address - Street 1:5319 16TH AVE STE A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-1431
Practice Address - Country:US
Practice Address - Phone:718-851-2663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150782207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY18N011OtherNEIGHBORHOOD HEALTH PLAN
KS308OtherOXFORD HEALTH PLANS
NY00991800Medicaid
NY150782OtherNY STATE LICENSE
NY150782OtherNY STATE LICENSE
NY84D621Medicare ID - Type Unspecified
NY18N011OtherNEIGHBORHOOD HEALTH PLAN