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Individual

MR. ELIJAH BERNARD STEVENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ANP, NPP

Contact information

Practice address
305 MAIN ST FL 2, BINGHAMTON, NY 13905-2524
(315) 663-4800
Mailing address
PO BOX 2153, LIVERPOOL, NY 13089-2153
(315) 663-4800

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
F3028621
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F4018441
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F3028621
NP LICENCE NUMBER
NY
01
F4018441
NP LICENCE NUMBER
NY
Enumeration date
10/02/2006
Last updated
03/07/2023
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