Provider Demographics
NPI:1568476729
Name:MCKENZIE, STEVEN E (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:MCKENZIE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1015 CHESTNUT STREET
Mailing Address - Street 2:SUITE 1321
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4310
Mailing Address - Country:US
Mailing Address - Phone:215-955-4730
Mailing Address - Fax:215-503-9188
Practice Address - Street 1:1015 CHESTNUT STREET
Practice Address - Street 2:SUITE 1321
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4310
Practice Address - Country:US
Practice Address - Phone:215-955-4730
Practice Address - Fax:215-503-9188
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2014-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD036838E207R00000X, 207RX0202X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001252245Medicaid
NJ2170108Medicaid
PA681172Medicare PIN