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General NPI Number Information
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NPI Number | 1568688091
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Entity Type | Individual
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Provider Name | DEBORAH LYNN STARK PSYD
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Gender | Female
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 19 WEST 34TH ST PH
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City | NEW YORK
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State | NY
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Zip | 10001
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Country | US
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Telephone | 212-744-2912
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Fax | 212-744-0293
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Provider Business Mailing Address
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Address Line | 444 EAST 86TH ST APT 22A
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City | NEW YORK
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State | NY
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Zip | 10028
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Country | US
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Telephone | 212-744-2912
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Fax | 212-744-0293
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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 | 016389
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License Number State | NY
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