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NPI Code Detail

MEDICARE: MR. BRIAN DALE STANLEY M.S.,B.S.

MEDICARE:  MR. BRIAN DALE STANLEY  M.S.,B.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor388535031NY
2103K00000XBehavior Analyst388535031NY

General Provider Information

NPI Number : 1043595549
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN DALE STANLEY M.S.,B.S.
Provider Business Mailing Address
First Line : 33 BRADHURST AVE 4TH FLOOR
Second Line :
City : NEW YORK
State : NY
Zip : 10030
Country : US
Telephone Number : 212-491-3541
Fax Number :
Provider Business Practice Location Address
First Line : 33 BRADHURST AVE APT 4
Second Line :
City : NEW YORK
State : NY
Zip : 10030-1389
Country : US
Telephone Number : 212-491-3541
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2011
Last Update Date : 10/15/2011

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Directions to “ MR. BRIAN DALE STANLEY M.S.,B.S.” Practice Location

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