Provider Demographics
NPI:1174951602
Name:ALEX SHTEYNSHLYUGER MD PC
Entity type:Organization
Organization Name:ALEX SHTEYNSHLYUGER MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SHTEYNSHLYUGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-663-5252
Mailing Address - Street 1:33 W 46TH ST FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4103
Mailing Address - Country:US
Mailing Address - Phone:646-663-5252
Mailing Address - Fax:718-285-8555
Practice Address - Street 1:33 W 46TH ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4103
Practice Address - Country:US
Practice Address - Phone:646-663-5252
Practice Address - Fax:718-285-8555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-18
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM1300X
NY250902208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty