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General NPI Number Information
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NPI Number | 1578794855
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Entity Type | Organization
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Legal Business Name | STANLEY L. PORTNOW, M.D., P.C.
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Dates
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Enumeration Date | 08/04/2009
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Last Update Date | 08/04/2009
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Provider Practice Location Address
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Address Line | 435 E 79TH ST SUITE 1BC
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City | NEW YORK
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State | NY
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Zip | 10075
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Country | US
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Telephone | 212-288-1877
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Fax |
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Provider Business Mailing Address
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Address Line | 435 E. 79TH STREET SUITE 1 B-C
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City | NEW YORK CITY
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State | NY
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Zip | 10075-1071
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Country | US
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Telephone | 212-288-1877
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Fax | 914-723-6160
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STANLEY LEWIS PORTNOW
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Credential | M.D.
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Telephone | 212-288-1877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 081538-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084F0202X
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Taxonomy Name | Forensic Psychiatry Physician
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License Number | 081538-1
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License Number State | NY
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