Provider Demographics
NPI:1184861585
Name:PHILLIPSON, STEVEN (DR)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:PHILLIPSON
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 E 36TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3528
Mailing Address - Country:US
Mailing Address - Phone:212-686-6886
Mailing Address - Fax:212-686-0943
Practice Address - Street 1:137 E 36TH ST STE 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3528
Practice Address - Country:US
Practice Address - Phone:212-686-6886
Practice Address - Fax:212-686-0943
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10863103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV4A341Medicaid