Provider Demographics
NPI:1407967243
Name:LEVEY, STEPHANIE BENZAQUEN (PHD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:BENZAQUEN
Last Name:LEVEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 E 83RD ST
Mailing Address - Street 2:SUITE 7E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2408
Mailing Address - Country:US
Mailing Address - Phone:212-203-6710
Mailing Address - Fax:
Practice Address - Street 1:135 E 83RD ST
Practice Address - Street 2:SUITE 7E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2408
Practice Address - Country:US
Practice Address - Phone:212-203-6710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016009-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVM6161Medicare ID - Type Unspecified