Provider Demographics
NPI:1902069024
Name:ALTMAYER, STEVEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:ALTMAYER
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 1:264 WASHINGTON AVENUE EXT STE 201
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-6352
Mailing Address - Country:US
Mailing Address - Phone:518-452-1928
Mailing Address - Fax:518-362-1348
Practice Address - Street 1:264 WASHINGTON AVENUE EXT STE 201
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-6352
Practice Address - Country:US
Practice Address - Phone:518-452-1928
Practice Address - Fax:518-362-1348
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA253994207N00000X
NY2785761207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110095780/AMedicaid
MA002844902Medicare PIN