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NPI Code Detail

MEDICARE: STEPHANIE JOSEPH PHD

MEDICARE:   STEPHANIE  JOSEPH  PHD
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
12084P0804XChild & Adolescent Psychiatry Physician027737NY
2103TC2200XClinical Child & Adolescent Psychologist027737NY

General Provider Information

NPI Number : 1710661582
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE JOSEPH PHD
Provider Business Mailing Address
First Line : 1645 E 53RD ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-3915
Country : US
Telephone Number : 347-822-3551
Fax Number :
Provider Business Practice Location Address
First Line : 622 W 168TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3720
Country : US
Telephone Number : 929-505-3844
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2023
Last Update Date : 05/21/2026

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Directions to “ STEPHANIE JOSEPH PHD” Practice Location

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