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General NPI Number Information
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NPI Number | 1467855130
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Entity Type | Individual
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Provider Name | STEVEN BASHKOFF PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/08/2014
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 286 5TH AVE 7F
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City | NEW YORK
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State | NY
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Zip | 10001-4512
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Country | US
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Telephone | 917-375-2037
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Fax |
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Provider Business Mailing Address
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Address Line | 595 MAIN ST APT 812
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City | NEW YORK
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State | NY
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Zip | 10044-0046
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Country | US
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Telephone |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 019031
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License Number State | NY
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