Individual
STEPHEN PETER RAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2270 KIMBALL ST, STW 206, BROOKLYN, NY 11234-5139
(718) 377-0011
(718) 377-0011
Mailing address
80 MARCUS DR, PROVIDER ENROLLMENT, MELVILLE, NY 11747-4230
(631) 391-7887
(631) 454-4163
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
114186
NY
208000000X
Pediatrics Physician
114186
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00430924
—
NY
01
—
P452722
OXFORD
NY
Enumeration date
10/10/2005
Last updated
01/17/2013
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