Provider Demographics
NPI:1376971572
Name:DULSKI, STEPHEN N
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:N
Last Name:DULSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 OLD KINGS HWY N
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4735
Mailing Address - Country:US
Mailing Address - Phone:203-309-5400
Mailing Address - Fax:
Practice Address - Street 1:53 OLD KINGS HWY N
Practice Address - Street 2:SUITE 204
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4735
Practice Address - Country:US
Practice Address - Phone:203-309-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3224103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical