Provider Demographics
NPI:1992748826
Name:PAPPAS, STEVEN WALDEN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WALDEN
Last Name:PAPPAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:875 MAMARONECK AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-1976
Mailing Address - Country:US
Mailing Address - Phone:914-793-1115
Mailing Address - Fax:914-793-2659
Practice Address - Street 1:875 MAMARONECK AVE STE 202
Practice Address - Street 2:
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-1976
Practice Address - Country:US
Practice Address - Phone:914-793-1115
Practice Address - Fax:914-793-2659
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140803207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY92A771Medicare ID - Type Unspecified
NYB78923Medicare UPIN