Provider Demographics
NPI:1629186036
Name:ZURROW, STEPHEN ALAN (PHD)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:ALAN
Last Name:ZURROW
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 WEST 72ND ST
Mailing Address - Street 2:SUITE 2RR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3278
Mailing Address - Country:US
Mailing Address - Phone:212-724-5360
Mailing Address - Fax:212-724-5360
Practice Address - Street 1:125 WEST 72ND ST
Practice Address - Street 2:SUITE 2RR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3278
Practice Address - Country:US
Practice Address - Phone:212-724-5360
Practice Address - Fax:212-724-5360
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0055041103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV58291Medicare ID - Type Unspecified