Provider Demographics
NPI:1154370245
Name:COLEN, STEPHEN ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ROBERT
Last Name:COLEN
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 1:742 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4251
Mailing Address - Country:US
Mailing Address - Phone:212-988-8900
Mailing Address - Fax:212-772-1308
Practice Address - Street 1:742 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4251
Practice Address - Country:US
Practice Address - Phone:212-988-8900
Practice Address - Fax:212-772-1308
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY137908204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine