Provider Demographics
NPI:1841577038
Name:ZWICK, STANLEY RICHARD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:RICHARD
Last Name:ZWICK
Suffix:
Gender:M
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 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3027
Mailing Address - Country:US
Mailing Address - Phone:516-825-7485
Mailing Address - Fax:
Practice Address - Street 1:365 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3027
Practice Address - Country:US
Practice Address - Phone:516-825-7485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009789-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist