Provider Demographics
NPI:1982093175
Name:YAGERMAN, STEVEN JAY (LP)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JAY
Last Name:YAGERMAN
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 E 60TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1402
Mailing Address - Country:US
Mailing Address - Phone:917-453-1158
Mailing Address - Fax:212-758-0447
Practice Address - Street 1:234 E 60TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1402
Practice Address - Country:US
Practice Address - Phone:917-453-1158
Practice Address - Fax:212-758-0447
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000914-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst