Provider Demographics
NPI:1700180528
Name:TEICH, STEPHEN STUART (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:STUART
Last Name:TEICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-3215
Mailing Address - Country:US
Mailing Address - Phone:212-741-1909
Mailing Address - Fax:212-463-9081
Practice Address - Street 1:40 W 24TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-3215
Practice Address - Country:US
Practice Address - Phone:212-741-1909
Practice Address - Fax:212-463-9081
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-08
Last Update Date:2011-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG251012084P0800X
NY1027562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry