# 58TH STREET MEDICAL, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548552276
- **Authorized official:** DR. STEVEN SIEGEL MD (OWNER)
- **Authorized official phone:** (718) 431-9870

## Contact information

- **Practice address:** 1153 58TH ST, BROOKLYN, NY 11219-4526
- **Practice address phone:** (718) 431-9870
- **Mailing address:** 1153 58TH ST, BROOKLYN, NY 11219-4526

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 162832 | NY | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 05/13/2011
- **Last updated:** 11/09/2011