Provider Demographics
NPI:1578824629
Name:KAHN, STEFANIE LYNN (MS-ED)
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:LYNN
Last Name:KAHN
Suffix:
Gender:F
Credentials:MS-ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 COMMUNITY PL
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-1918
Mailing Address - Country:US
Mailing Address - Phone:914-774-6359
Mailing Address - Fax:
Practice Address - Street 1:8 COMMUNITY PL
Practice Address - Street 2:
Practice Address - City:PUTNAM VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10579-1918
Practice Address - Country:US
Practice Address - Phone:914-774-6359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1569605174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1569605OtherTEACHING LICENSE