Healthcare Provider Details

I. General information

NPI: 1982995239
Provider Name (Legal Business Name): STEVEN A. STANDIFORD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 04/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 TRAVIS PL
HASTINGS ON HUDSON NY
10706-1706
US

IV. Provider business mailing address

8 TRAVIS PL
HASTINGS ON HUDSON NY
10706-1706
US

V. Phone/Fax

Practice location:
  • Phone: 914-478-7801
  • Fax:
Mailing address:
  • Phone: 914-478-7801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR056560-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: