Provider Demographics
NPI:1063562759
Name:LUND, STEPHEN ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ARTHUR
Last Name:LUND
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 1:200 RIVERSIDE BLVD
Mailing Address - Street 2:APARTMENT 18J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10069-0901
Mailing Address - Country:US
Mailing Address - Phone:917-441-9817
Mailing Address - Fax:
Practice Address - Street 1:423 W 55TH ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4460
Practice Address - Country:US
Practice Address - Phone:212-994-4570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1901842084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF62457Medicare UPIN
NY80H421Medicare PIN