Provider Demographics
NPI:1053302067
Name:GORFINE, STEPHEN RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:RICHARD
Last Name:GORFINE
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 1:68 EAST 86TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028
Mailing Address - Country:US
Mailing Address - Phone:212-517-8600
Mailing Address - Fax:212-535-3717
Practice Address - Street 1:68 EAST 86TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028
Practice Address - Country:US
Practice Address - Phone:212-517-8600
Practice Address - Fax:212-535-3717
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY139014208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA63663Medicare UPIN