Provider Demographics
NPI:1043546245
Name:SHTEYNBERG, ALEKSANDR (MD)
Entity type:Individual
Prefix:
First Name:ALEKSANDR
Middle Name:
Last Name:SHTEYNBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:791 PARK AVE APT 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3512
Mailing Address - Country:US
Mailing Address - Phone:212-951-1877
Mailing Address - Fax:
Practice Address - Street 1:791 PARK AVE APT 1B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3512
Practice Address - Country:US
Practice Address - Phone:212-951-1877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-22
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY248881208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03192532Medicaid
NY03192532Medicaid