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General NPI Number Information
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NPI Number | 1497974505
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Entity Type | Individual
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Provider Name | STEPHANIE S. COYNE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 10/03/2007
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Provider Practice Location Address
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Address Line | 106 OLD HOOK RD
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City | WESTWOOD
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State | NJ
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Zip | 07675-2400
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Country | US
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Telephone | 201-666-5515
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Fax | 201-666-8475
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Provider Business Mailing Address
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Address Line | 645 WESTWOOD AVE STE 303
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City | RIVERVALE
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State | NJ
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Zip | 07675-6295
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Country | US
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Telephone | 201-666-5515
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Fax | 201-666-8475
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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 | 2867
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License Number State | NJ
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