Provider Demographics
NPI:1992706485
Name:BECKER, STEVEN BRIAN (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:BRIAN
Last Name:BECKER
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 1:539 CLEVELAND DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225-1024
Mailing Address - Country:US
Mailing Address - Phone:716-837-7130
Mailing Address - Fax:716-834-6466
Practice Address - Street 1:539 CLEVELAND DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14225-1024
Practice Address - Country:US
Practice Address - Phone:716-837-7130
Practice Address - Fax:716-834-6466
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161094207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00886402Medicaid
NYB47991Medicare ID - Type Unspecified
NY00886402Medicaid