Individual
DR. STANLEY BODNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1579 E 29TH ST, BROOKLYN, NY 11229-1846
(718) 339-4916
(718) 339-5997
Mailing address
1579 E 29TH ST, BROOKLYN, NY 11229-1846
(718) 339-4916
(718) 339-5997
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6557-1
NY
103TA0400X
Addiction (Substance Use Disorder) Psychologist
6557-1
NY
103TB0200X
Cognitive & Behavioral Psychologist
6557-1
NY
103TC1900X
Counseling Psychologist
6557-1
NY
103TC2200X
Clinical Child & Adolescent Psychologist
6557-1
NY
Other
Enumeration date
09/08/2005
Last updated
05/07/2013
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