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DR. STEPHANIE LAILA ANISMATTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
1592 208TH PL, BAYSIDE, NY 11360-1122
(908) 202-3684
Mailing address
1592 208TH PL, BAYSIDE, NY 11360-1122
(908) 202-3684

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
025724
NY

Other

Enumeration date
11/22/2022
Last updated
02/21/2024
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