Doctor Name: | DR. LAWRENCE S STALLMAN |
NPI Number: | 1093859282 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 6155-1 |
Business Practice Address: | 413 Kenwood Ave Delmar, NY - 120543231 |
Business Phone Number: | 5184390090 |
Business Fax Number: | 5184390267 |
Mailing Address: | 872 Myrtle Ave, ALBANY |
State: | NY |
Postal Code: | 122082608 |
Phone Number: | 5184589304 |
Fax Number: | 5184589304 |
NPI Enumeration Date: | 02/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6155-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |