Provider Demographics
NPI:1033189030
Name:EMMETT, STEVEN M (DO)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:EMMETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 QUENTIN ROAD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4209
Mailing Address - Country:US
Mailing Address - Phone:718-339-5544
Mailing Address - Fax:718-339-4892
Practice Address - Street 1:3104 QUENTIN ROAD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4209
Practice Address - Country:US
Practice Address - Phone:718-339-5544
Practice Address - Fax:718-339-4892
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103132208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
101031OtherUS HEALTH CARE
4060662OtherAETNA
512791OtherBLUE CROSS
970853OtherHERITAGE
0381855OtherCIGNA
P963767OtherOXFORD
1201394OtherUNITED HEALTH CARE
OP147OtherHIP
OP147OtherHIP