Individual
DR. JAKE STEPHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1630 RICHMOND RD, STATEN ISLAND, NY 10304-2322
(718) 339-7100
(718) 339-3071
Mailing address
1630 RICHMOND RD, STATEN ISLAND, NY 10304-2322
(718) 339-7100
(718) 339-3071
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
335037
NY
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
335037
NY
Other
Enumeration date
04/29/2020
Last updated
01/08/2026
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