Provider Demographics
NPI:1336298728
Name:VIANI, STEVEN J (PHD, CASAC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:VIANI
Suffix:
Gender:M
Credentials:PHD, CASAC
Other - Prefix:DR
Other - First Name:STEVEN
Other - Middle Name:J
Other - Last Name:VIANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, CASAC
Mailing Address - Street 1:7826 79TH PL
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7438
Mailing Address - Country:US
Mailing Address - Phone:718-366-9551
Mailing Address - Fax:
Practice Address - Street 1:110-21 73RD ROAD
Practice Address - Street 2:SUITE 1J
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6348
Practice Address - Country:US
Practice Address - Phone:718-366-1534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07669103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical