Basic Information
| Provider Information | |||||||||
| NPI: | 1992930945 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEIN | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | I | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 121 EVERETT RD | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122051474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184539088 | ||||||||
| FaxNumber: | 5186893895 | ||||||||
| Practice Location | |||||||||
| Address1: | 121 EVERETT RD | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122051474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184539088 | ||||||||
| FaxNumber: | 5186893895 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/20/2009 | ||||||||
| LastUpdateDate: | 05/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 278524 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.