Provider Demographics
NPI:1720308299
Name:STOPANIO, JOSEPH ANTHONY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:STOPANIO
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 1:11 SPARROW LN
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2221
Mailing Address - Country:US
Mailing Address - Phone:516-376-0950
Mailing Address - Fax:
Practice Address - Street 1:11 SPARROW LN
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2221
Practice Address - Country:US
Practice Address - Phone:516-376-0950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017662103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral