Provider Demographics
NPI:1730229337
Name:STEIN, NORMAN DONALD (PHD)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:DONALD
Last Name:STEIN
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 1:19 WALTON AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-3212
Mailing Address - Country:US
Mailing Address - Phone:914-328-1760
Mailing Address - Fax:914-328-1760
Practice Address - Street 1:280 N CENTRAL AVE
Practice Address - Street 2:SUITE 45
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1832
Practice Address - Country:US
Practice Address - Phone:914-328-1760
Practice Address - Fax:914-949-7675
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8306103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0023753OtherGHI
NYS08306-3OtherWORKER'S COMPENSATION
NY4335141OtherAETNA-US HEALTHCARE
NY06008306NY01OtherANTHEM
NY1059560OtherBEACON
NY00953920Medicaid
NYR52162Medicare UPIN
NYV50621Medicare ID - Type Unspecified