Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 036474 | NY |
Y | 213EG0000X | General Practice | 036474 | NY |
NPI | 1992927701 |
---|---|
Provider Name | Steven R Acker |
First Address | Staten Island, NY 10314-6625 |
Second Address | Staten Island, NY 10314-6625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 08/07/2007 |