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General NPI Number Information
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NPI Number | 1265451785
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Entity Type | Individual
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Provider Name | STEPHEN GERSTEN PSY. D
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Gender | Male
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1670-78 EAST 17TH STREET 1ST FL.
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City | BROOKLYN
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State | NY
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Zip | 11229
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Country | US
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Telephone | 646-491-3711
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Fax |
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Provider Business Mailing Address
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Address Line | 615 ALONZO RD
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-4805
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Country | US
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Telephone | 718-337-3476
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0164721
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License Number State | NY
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