Individual
STEPHANIE L MICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
525 E 68TH ST STE M404, NEW YORK, NY 10065-4870
(212) 746-6707
(646) 962-0108
Mailing address
525 E 68TH ST STE M-404, NEW YORK, NY 10065-4870
(212) 746-6707
(646) 962-0529
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
228855
NY
208600000X
Surgery Physician
35.098015
OH
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
228855
NY
Other
Enumeration date
11/20/2006
Last updated
08/03/2023
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