Provider Demographics
NPI:1093407132
Name:STACY SCHOENBACH, NURSE PRACTITIONER PSYCHIATRIC SERVICES PC
Entity Type:Organization
Organization Name:STACY SCHOENBACH, NURSE PRACTITIONER PSYCHIATRIC SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:631-707-2394
Mailing Address - Street 1:200 BROADHOLLOW RD STE 207
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4806
Mailing Address - Country:US
Mailing Address - Phone:631-707-2394
Mailing Address - Fax:631-824-9118
Practice Address - Street 1:200 BROADHOLLOW RD STE 207
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4806
Practice Address - Country:US
Practice Address - Phone:631-707-2394
Practice Address - Fax:631-824-9118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty