Provider Demographics
NPI:1538258538
Name:MAYER, STEPHAN ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHAN
Middle Name:ANTHONY
Last Name:MAYER
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:WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES
Mailing Address - Street 2:19 BRADHURST AVENUE, SUITE 3100N
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532
Mailing Address - Country:US
Mailing Address - Phone:914-909-9018
Mailing Address - Fax:914-909-9028
Practice Address - Street 1:WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES
Practice Address - Street 2:100 WOODS ROAD
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-5098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1822312084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01522861Medicaid
NY01522861Medicaid
NY02J621Medicare ID - Type Unspecified