Provider Demographics
NPI:1932836863
Name:STEPHANIE SAMAR PSYD PC
Entity Type:Organization
Organization Name:STEPHANIE SAMAR PSYD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:646-475-0922
Mailing Address - Street 1:185 MADISON AVE STE 1406
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4325
Mailing Address - Country:US
Mailing Address - Phone:646-475-0922
Mailing Address - Fax:646-948-1270
Practice Address - Street 1:185 MADISON AVE STE 1406
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4325
Practice Address - Country:US
Practice Address - Phone:646-475-0922
Practice Address - Fax:646-948-1270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty