Provider Demographics
NPI:1932070422
Name:GULLO, STEPHEN VITON (PHD PSYCHOLOGY)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:VITON
Last Name:GULLO
Suffix:
Gender:M
Credentials:PHD PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 63RD ST APT 18G
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7418
Mailing Address - Country:US
Mailing Address - Phone:917-656-0305
Mailing Address - Fax:
Practice Address - Street 1:205 E 63RD ST APT 18G
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7418
Practice Address - Country:US
Practice Address - Phone:917-656-0305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002549103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service