Provider Demographics
NPI:1124336656
Name:YALKOWSKY, STEVEN ROBERT (PHD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ROBERT
Last Name:YALKOWSKY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 N BROADWAY APT 2E
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-2124
Mailing Address - Country:US
Mailing Address - Phone:914-424-1871
Mailing Address - Fax:
Practice Address - Street 1:1 GATEWAY CTR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-5310
Practice Address - Country:US
Practice Address - Phone:914-424-1871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100480400103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral