Individual
STEPHEN J. BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1339 YORK AVE, NEW YORK, NY 10021-4707
(212) 628-2800
Mailing address
254 W 10TH ST, NEW YORK, NY 10014-6422
(212) 645-0970
(212) 627-2395
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
143786
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01081034
—
NY
Enumeration date
03/04/2007
Last updated
08/14/2024
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