Stefanie Mary Iwanciw, PsyD
Psychologist, Clinical in Glen Oaks, NY. Individual provider (NPI-1).
NPI number1003484635
StatusActive
Last updated in NPPESJul 14, 2021
Details
- NPI
- 1003484635
- Entity type
- Individual (NPI-1)
- Name
- Stefanie Mary Iwanciw
- Credential
- PsyD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 10, 2021
- Certification date
- Jul 14, 2021
- Last updated
- Jul 14, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 024406 | NY | Yes |
| 103T00000X | Psychologist | – | – |
Practice location
7559 263rd StGlen Oaks, NY 11004-1150
Phone 718-470-8060
Mailing address
7559 263rd StGlen Oaks, NY 11004-1150
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