Provider Demographics
NPI:1598210254
Name:LAWRENCE STEIN, PHD., PA
Entity Type:Organization
Organization Name:LAWRENCE STEIN, PHD., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE STEIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:732-747-8818
Mailing Address - Street 1:316 BROAD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2155
Mailing Address - Country:US
Mailing Address - Phone:732-747-8818
Mailing Address - Fax:732-747-8918
Practice Address - Street 1:316 BROAD ST STE 1
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2155
Practice Address - Country:US
Practice Address - Phone:732-747-8818
Practice Address - Fax:732-747-8918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-23
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty