Provider Demographics
NPI:1215173984
Name:DR. ROBERT E. STOESSEL, PSYCHOLOGIST, P.C,
Entity type:Organization
Organization Name:DR. ROBERT E. STOESSEL, PSYCHOLOGIST, P.C,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:STOESSEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:631-828-4741
Mailing Address - Street 1:5 MEADOW POND CIR
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-3808
Mailing Address - Country:US
Mailing Address - Phone:631-828-4741
Mailing Address - Fax:631-337-6867
Practice Address - Street 1:5 MEADOW POND CIR
Practice Address - Street 2:
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-3808
Practice Address - Country:US
Practice Address - Phone:631-828-4741
Practice Address - Fax:631-337-6867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009078261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)