Provider Demographics
NPI:1104932508
Name:STEIN, PERRY J (MD)
Entity type:Individual
Prefix:
First Name:PERRY
Middle Name:J
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:383 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4701
Mailing Address - Country:US
Mailing Address - Phone:718-941-6000
Mailing Address - Fax:718-941-6071
Practice Address - Street 1:383 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4701
Practice Address - Country:US
Practice Address - Phone:718-941-6000
Practice Address - Fax:718-941-6071
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2013-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY172301208100000X, 2278P3800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2278P3800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedPalliative/Hospice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01369846Medicaid
NY01369846Medicaid