Provider Demographics
NPI:1447594874
Name:STANZIONE, CATHERINE (PSYD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:STANZIONE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PRESCOTT ST
Mailing Address - Street 2:
Mailing Address - City:DEMAREST
Mailing Address - State:NJ
Mailing Address - Zip Code:07627
Mailing Address - Country:US
Mailing Address - Phone:201-788-1115
Mailing Address - Fax:
Practice Address - Street 1:354 OLD HOOK RD STE 203
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3248
Practice Address - Country:US
Practice Address - Phone:201-788-1115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4608103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist