Individual
STEPHEN GOLUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
118 NORTH COUNTRY ROAD, PORT JEFFERSON, NY 11777
(631) 473-7171
(631) 473-4605
Mailing address
118 NORTH COUNTRY ROAD, PORT JEFFERSON, NY 11777
(631) 473-7171
(631) 473-4605
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
142187
NY
207VG0400X
Gynecology Physician
Primary
1421871
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1421871
STATE LIC
NY
01
—
1461871
NYS LICENSE
NY
Enumeration date
12/04/2006
Last updated
03/07/2023
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