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General NPI Number Information
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NPI Number | 1992428957
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Entity Type | Individual
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Provider Name | STEPHANIE CALDAS
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Gender | Female
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Dates
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Enumeration Date | 09/23/2022
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Last Update Date | 05/03/2023
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Provider Practice Location Address
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Address Line | 1 PARK AVE FL 7
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City | NEW YORK
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State | NY
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Zip | 10016-5818
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Country | US
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Telephone | 212-263-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 110 SIDNEY ST
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City | OYSTER BAY
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State | NY
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Zip | 11771-1612
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Country | US
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Telephone | 337-501-6467
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 025260
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License Number State | NY
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