Individual
STEPHEN THECCANAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 923-6900
(732) 923-6914
Mailing address
PO BOX 8000, DEPT 601, BUFFALO, NY 14267-0002
(866) 295-0041
(708) 342-2517
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25MA06166600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7203608
—
NJ
Enumeration date
11/14/2006
Last updated
10/14/2011
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