Provider Demographics
NPI:1598587685
Name:STACY POPKIN-ZANG, PSYD, PLLC
Entity type:Organization
Organization Name:STACY POPKIN-ZANG, PSYD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:POPKIN-ZANG
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:631-626-5186
Mailing Address - Street 1:70 GLEN COVE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1730
Mailing Address - Country:US
Mailing Address - Phone:631-626-5186
Mailing Address - Fax:
Practice Address - Street 1:70 GLEN COVE RD STE 201
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1730
Practice Address - Country:US
Practice Address - Phone:631-626-5186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Single Specialty