Individual provider Active NPI

Stephanie Panush Dubow, D.O.

  • Clinical Neurophysiology Physician
  • New York, NY
National Provider Identifier
1548416639
Registry record updated Nov 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
255320-1 Issued in NY
Practice address
19 E 37TH St
New York, NY 10016-3005
Phone
(212) 239-2112
NPI assigned
Aug 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 036120408 IL
Clinical Neurophysiology Physician 2084N0600X 255320-1 NY Primary

Addresses

Primary practice location

19 E 37TH St
New York, NY 10016-3005

Mailing address

19 E 37TH St
New York, NY 10016-3005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036120408ILMDClinical Neurophysiology Physician
255320-1NYMDClinical Neurophysiology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1548416639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 E 37TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E 37TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100163005",
            "telephone_number": "212-239-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOW",
        "first_name": "STEPHANIE",
        "middle_name": "PANUSH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-08",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "IL",
            "license": "036120408",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NY",
            "license": "255320-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.