Provider Demographics
NPI:1538173067
Name:SPRINGER, STUART I (MD)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:I
Last Name:SPRINGER
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 1:424 MADISON AVE FL 9
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1164
Mailing Address - Country:US
Mailing Address - Phone:212-813-2543
Mailing Address - Fax:212-813-2519
Practice Address - Street 1:424 MADISON AVE
Practice Address - Street 2:9 FL.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1106
Practice Address - Country:US
Practice Address - Phone:212-813-2543
Practice Address - Fax:212-813-2519
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY108983174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY571171Medicare ID - Type Unspecified
NYB16710Medicare UPIN