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NPI Code Detail

MEDICARE: DR. PATRICIA ANN STEVENS PH.D.

MEDICARE:  DR. PATRICIA ANN STEVENS  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist007659-1NY

General Provider Information

NPI Number : 1487728333
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICIA ANN STEVENS PH.D.
Provider Business Mailing Address
First Line : 457 12TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-5101
Country : US
Telephone Number : 718-499-5990
Fax Number : 718-499-5990
Provider Business Practice Location Address
First Line : 457 12TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-5101
Country : US
Telephone Number : 718-499-5990
Fax Number : 718-499-5990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2006
Last Update Date : 07/08/2007

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