Provider Demographics
NPI:1134251416
Name:KNOBLAUCH, STEVEN HUGH (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:HUGH
Last Name:KNOBLAUCH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 WEST 9TH STREET #3B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8923
Mailing Address - Country:US
Mailing Address - Phone:212-243-6202
Mailing Address - Fax:718-499-3089
Practice Address - Street 1:26 W 9TH ST APT 3B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8923
Practice Address - Country:US
Practice Address - Phone:212-243-6202
Practice Address - Fax:718-499-3089
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011696-1103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis