Provider Demographics
NPI:1477219939
Name:LEWIN, STEPHANIE IRIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:IRIS
Last Name:LEWIN
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 1:29 TIFFANY PL APT 4I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-2998
Mailing Address - Country:US
Mailing Address - Phone:917-626-0978
Mailing Address - Fax:
Practice Address - Street 1:18 E 16TH ST RM 503
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3111
Practice Address - Country:US
Practice Address - Phone:917-626-0978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014739103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist