Doctor Name: | DR. STEPHEN J KRAVCHUCK |
NPI Number: | 1821246315 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D, |
License Number: | 37PC00376500 |
Business Practice Address: | 140 S. Broadway #7 Pitman, NJ - 080712417 |
Business Phone Number: | 8443657676 |
Business Fax Number: | 8443657676 |
Mailing Address: | Po Box 211, PITMAN |
State: | NJ |
Postal Code: | 080710211 |
Phone Number: | 8443657676 |
Fax Number: | 8443657676 |
NPI Enumeration Date: | 09/09/2008 |
NPI Last Update Date: | 09/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 37PC00376500 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |