| Doctor Name: | MR. ELIJAH BERNARD STEVENS |
| NPI Number: | 1326131954 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSN, ANP |
| License Number: | F3028621 |
| Business Practice Address: | 217 Rabbit Run Rd Clintondale, NY - 125155038 |
| Business Phone Number: | 3154503768 |
| Business Fax Number: | |
| Mailing Address: | 217 Rabbit Run Rd, CLINTONDALE |
| State: | NY |
| Postal Code: | 125155038 |
| Phone Number: | 3154503776 |
| Fax Number: | |
| NPI Enumeration Date: | 10/02/2006 |
| NPI Last Update Date: | 07/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | F3028621 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |