Provider Demographics
NPI:1992763841
Name:STEIER, KENNETH JAY (DO)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:JAY
Last Name:STEIER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:KEN
Other - Middle Name:J
Other - Last Name:STEIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:69 OLD EAST NECK RD
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2811
Mailing Address - Country:US
Mailing Address - Phone:631-283-8008
Mailing Address - Fax:631-283-8870
Practice Address - Street 1:69 OLD EAST NECK RD
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2811
Practice Address - Country:US
Practice Address - Phone:631-283-8008
Practice Address - Fax:631-283-8870
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220033207RC0200X, 207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY23R141OtherBLUE CROSS
NY02613454Medicaid
NY02613454Medicaid
NY23R141OtherBLUE CROSS