Provider Demographics
NPI:1558461848
Name:STEWART, JULIE BRIGHT (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:BRIGHT
Last Name:STEWART
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 1:365 CEDAR AVENUE
Mailing Address - Street 2:#1
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450
Mailing Address - Country:US
Mailing Address - Phone:347-804-4467
Mailing Address - Fax:
Practice Address - Street 1:1651 THIRD AVENUE
Practice Address - Street 2:STE 201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128
Practice Address - Country:US
Practice Address - Phone:347-804-4467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0139691103T00000X
NJ35S100408300103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P06425Medicare UPIN
NYVS0461Medicare ID - Type Unspecified