Provider Demographics
NPI:1720062276
Name:LOWENSTEIN, BRUCE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:
Last Name:LOWENSTEIN
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 1:2 HOOVER LN
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-1004
Mailing Address - Country:US
Mailing Address - Phone:845-362-8382
Mailing Address - Fax:845-362-8382
Practice Address - Street 1:2 HOOVER LN
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-1004
Practice Address - Country:US
Practice Address - Phone:845-362-8382
Practice Address - Fax:845-362-8382
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010124-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6800081OtherGHI
NYR19316Medicare UPIN
NY6800081OtherGHI