Provider Demographics
NPI:1124180955
Name:STEIN, DEBRA M (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:M
Last Name:STEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ROBERTA LN
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3815
Mailing Address - Country:US
Mailing Address - Phone:513-617-4823
Mailing Address - Fax:
Practice Address - Street 1:1300 WATERS PL
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2714
Practice Address - Country:US
Practice Address - Phone:929-348-3693
Practice Address - Fax:929-348-3735
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-08-0397208000000X
NY204966208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics