Individual
KENT MARTIN STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 ROE AVENUE, SUITE 1A, ELMIRA, NY 14905-1629
(607) 737-4130
(607) 737-4530
Mailing address
571 SAINT JOSEPHS BLVD, FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
(607) 271-2099
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
215891
NY
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
215891
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02822920
—
NY
05
—
103615183
—
PA
Enumeration date
09/29/2005
Last updated
12/01/2020
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