Provider Demographics
NPI:1912348632
Name:NORTH SHORE PSYCHOLOGY
Entity Type:Organization
Organization Name:NORTH SHORE PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:STOPANIO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:516-376-0950
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:516-376-0950
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:516-376-0950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017662103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty