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General NPI Number Information
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NPI Number | 1558008649
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Entity Type | Organization
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Legal Business Name | BRADFORD L. STEVENS PSYCHOLOGY, P.C.
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Dates
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Enumeration Date | 05/19/2022
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 300 E 75TH ST APT 20M
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City | NEW YORK
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State | NY
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Zip | 10021-3377
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Country | US
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Telephone | 917-626-4364
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E 75TH ST APT 20M
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City | NEW YORK
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State | NY
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Zip | 10021-3377
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Country | US
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Telephone | 917-626-4364
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRADFORD L. STEVENS
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Credential | PHD
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Telephone | 917-626-4364
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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 |
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License Number State |
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