Basic Information
Provider Information
NPI: 1750374179
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOH
FirstName: STEVEN
MiddleName: SHINHAE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 100 ROUTE 59
Address2: SUITE 105
City: SUFFERN
State: NY
PostalCode: 109014927
CountryCode: US
TelephoneNumber: 8453575775
FaxNumber: 8453575777
Practice Location
Address1: 127 S BROADWAY
Address2:  
City: YONKERS
State: NY
PostalCode: 107014006
CountryCode: US
TelephoneNumber: 9143787000
FaxNumber: 8453575777
Other Information
ProviderEnumerationDate: 08/31/2005
LastUpdateDate: 06/20/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X196067-1NYY Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000X25MA06018100NJN Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
0186065905NY MEDICAID
0156649405NY MEDICAID
028387805NJ MEDICAID


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