Provider Demographics
NPI:1710078373
Name:MAIL, STUART JAY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STUART
Middle Name:JAY
Last Name:MAIL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 STRAWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-6835
Mailing Address - Country:US
Mailing Address - Phone:845-639-8039
Mailing Address - Fax:845-639-8039
Practice Address - Street 1:112 STRAWTOWN RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-6835
Practice Address - Country:US
Practice Address - Phone:845-639-8039
Practice Address - Fax:845-639-8039
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR028553-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02032846Medicaid
NYN66551Medicare ID - Type Unspecified