Individual
DR. STEVEN M TILLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3119 NEWTOWN AVE, SUITE 801, ASTORIA, NY 11102-1350
(718) 777-2111
(718) 732-2191
Mailing address
3119 NEWTOWN AVE, SUITE 801, ASTORIA, NY 11102-1350
(718) 777-2111
(718) 732-2191
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
1982311
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02057289
—
NY
Enumeration date
01/18/2006
Last updated
10/05/2012
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