Provider Demographics
NPI:1104832781
Name:STONE, KEVIN HUNTER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:HUNTER
Last Name:STONE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 WEST END AVE
Mailing Address - Street 2:#1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:212-662-9200
Mailing Address - Fax:
Practice Address - Street 1:910 WEST END AVE
Practice Address - Street 2:#1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:212-662-9200
Practice Address - Fax:212-932-0964
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14548103TC0700X
NY014548103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02173706Medicaid
NY02173706Medicaid