| Organization Name: | DR. ROBERT E. STOESSEL, PSYCHOLOGIST, P.C, |
| NPI Number: | 1215173984 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT EDWARD STOESSEL (PRESIDENT/OWNER) |
| Mailing Address: | 5 Meadow Pond Cir Miller Place |
| State: | NY US |
| Postal Code: | 117643808 |
| Phone Number: | 6318284741 |
| Fax Number: | 6313376867 |
| NPI Enumeration Date: | 12/30/2008 |
| NPI Last Update Date: | 12/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 009078 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |