Provider Demographics
NPI:1427111855
Name:STEVENSON, ELLEN M (MD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:M
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:180 FORT WASHINGTON AVE
Mailing Address - Street 2:HARKNESS PAVILION 250
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3735
Mailing Address - Country:US
Mailing Address - Phone:212-305-7386
Mailing Address - Fax:212-305-5800
Practice Address - Street 1:3 E 65TH ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6527
Practice Address - Country:US
Practice Address - Phone:212-305-7386
Practice Address - Fax:212-305-5800
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY158779-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry