Provider Demographics
NPI:1194739284
Name:DORO, STEPHEN (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:DORO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:80 MAIDEN LN
Mailing Address - Street 2:SUITE 508
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4811
Mailing Address - Country:US
Mailing Address - Phone:212-207-4537
Mailing Address - Fax:212-207-4929
Practice Address - Street 1:80 MAIDEN LN
Practice Address - Street 2:SUITE 508
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4811
Practice Address - Country:US
Practice Address - Phone:212-207-4537
Practice Address - Fax:212-207-4929
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY161396-1207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00967491Medicaid
NY00967491Medicaid
72D691Medicare ID - Type Unspecified