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Individual

DR. STEVEN BOURLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
789 OLD COUNTRY RD, PLAINVIEW, NY 11803-4907
(516) 433-3600
(516) 433-9490
Mailing address
4277 HEMPSTEAD TPKE, SUITE 209, BETHPAGE, NY 11714-5709
(516) 731-7770
(516) 731-7052

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
128336
NY
207RN0300X
Nephrology Physician
Primary
128336
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00887036
NY
01
1C4996
HEALTHNET
NY
01
AS530
OXFORD
NY
Enumeration date
06/21/2006
Last updated
02/22/2013
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