Provider Demographics
NPI:1891773529
Name:SCHONBUCH, STANLEY SIDNEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:SIDNEY
Last Name:SCHONBUCH
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 1:308 SEAVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2246
Mailing Address - Country:US
Mailing Address - Phone:718-987-3331
Mailing Address - Fax:718-987-6079
Practice Address - Street 1:308 SEAVIEW AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-2246
Practice Address - Country:US
Practice Address - Phone:718-987-3331
Practice Address - Fax:718-987-6079
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2010-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3589103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV21202Medicare ID - Type Unspecified