Most Relevant Information
Provider Data
| NPI Number: | 1003484635 |
| Provider Name: | STEFANIE MARY IWANCIW PSYD |
| Entity Type: | Individual |
| Taxonomy Code: | 103T00000X |
| Specialty: | Psychologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/10/2021 |
| Last Updated: | 07/14/2021 |
Provider Practice Location
7559 263RD ST
GLEN OAKS
NY
110041150
Practice Location Phone/Fax
| Phone: | 7184708060 |
| Fax: |
Provider Mailing Location
7559 263RD ST
GLEN OAKS
NY
110041150
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |