Provider Demographics
NPI:1972777613
Name:MEYERS, STANLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:MEYERS
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 1:30 W 60TH ST
Mailing Address - Street 2:APT 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7902
Mailing Address - Country:US
Mailing Address - Phone:212-633-6865
Mailing Address - Fax:212-645-0570
Practice Address - Street 1:30 W 60TH ST
Practice Address - Street 2:APT 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7902
Practice Address - Country:US
Practice Address - Phone:212-633-6865
Practice Address - Fax:212-645-0570
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2016-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5704103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical