| Doctor Name: | MR. STEPHEN COLLEEN |
| NPI Number: | 1407000524 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 003906 |
| Business Practice Address: | 14379 Route 9w Ravena, NY - 12143 |
| Business Phone Number: | 5187563124 |
| Business Fax Number: | 5187569476 |
| Mailing Address: | 537 Route 9w, GLENMONT |
| State: | NY |
| Postal Code: | 120773703 |
| Phone Number: | 5184367888 |
| Fax Number: | 5184629162 |
| NPI Enumeration Date: | 11/17/2008 |
| NPI Last Update Date: | 11/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | 003906 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |