Provider Demographics
NPI:1407913171
Name:STEIN, PHILIP D (PHD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:D
Last Name:STEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 FRANKLIN AVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5801
Mailing Address - Country:US
Mailing Address - Phone:516-739-2133
Mailing Address - Fax:516-739-2133
Practice Address - Street 1:400 MONTAUK HWY
Practice Address - Street 2:STE 106
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4429
Practice Address - Country:US
Practice Address - Phone:516-739-2133
Practice Address - Fax:516-739-2133
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009571103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist