Provider Demographics
NPI:1720150774
Name:STUMMER, STEVEN JEFFREY (DPM)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JEFFREY
Last Name:STUMMER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 VILLAGE HILL DR
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-8337
Mailing Address - Country:US
Mailing Address - Phone:516-449-1842
Mailing Address - Fax:
Practice Address - Street 1:2631 MERRICK RD STE 300
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-5784
Practice Address - Country:US
Practice Address - Phone:516-781-9800
Practice Address - Fax:631-754-2909
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005188213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01982Medicare PIN
NY4266960001Medicare NSC
NYP12592Medicare PIN
NYU56046Medicare UPIN