Provider Demographics
NPI:1902946015
Name:WELLS, STEVEN SHARRIEFF (DPM)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:SHARRIEFF
Last Name:WELLS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 HORIZON CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-1910
Mailing Address - Country:US
Mailing Address - Phone:844-777-8700
Mailing Address - Fax:917-791-9755
Practice Address - Street 1:594 ALBANY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1706
Practice Address - Country:US
Practice Address - Phone:718-245-7210
Practice Address - Fax:718-245-7469
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005481-1207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01925626Medicaid
NYPA9651Medicare ID - Type Unspecified
NY01925626Medicaid