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Organization
THEODORA STOLZ CLINIC
Active
Organization
THEODORA STOLZ CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORA STOLZ (PRESIDENT)
(718) 980-3780
Entity
Organization
Contact information
Practice address
68 GUYON AVE, S I, NY 10306
(718) 980-3780
(718) 987-6113
Mailing address
68 GUYON AVE, S I, NY 10306
(718) 980-3780
(718) 987-6113
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
010825
NY
103TC0700X
Clinical Psychologist
3222
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0028533
—
NJ
05
—
01627747
—
NY
Enumeration date
10/25/2006
Last updated
08/22/2020
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