Provider Demographics
NPI:1780825828
Name:PUCHNER, STEPHANIE NICOSIA (BS)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:NICOSIA
Last Name:PUCHNER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 177
Mailing Address - Street 2:
Mailing Address - City:VALATIE
Mailing Address - State:NY
Mailing Address - Zip Code:12184-0177
Mailing Address - Country:US
Mailing Address - Phone:518-929-1799
Mailing Address - Fax:
Practice Address - Street 1:845 CENTRAL AVE # 2
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1514
Practice Address - Country:US
Practice Address - Phone:518-369-8705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker