Individual
STEPHEN D WATERFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-6210
Mailing address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-6210
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
295004
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD476545
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05314127
—
NY
Enumeration date
11/03/2009
Last updated
06/10/2025
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