Provider Demographics
NPI:1366573396
Name:BECKER, STEPHEN JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOSEPH
Last Name:BECKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:JOSEPH
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4701 QUEENS BLVD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-1623
Mailing Address - Country:US
Mailing Address - Phone:718-779-8860
Mailing Address - Fax:718-779-8935
Practice Address - Street 1:4701 QUEENS BLVD
Practice Address - Street 2:SUITE 404
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-1623
Practice Address - Country:US
Practice Address - Phone:718-779-8860
Practice Address - Fax:718-779-8935
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169763207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine