| NPI | 1114049871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT B. DEVINNEY President 631-987-3780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 012661) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: NY 012661) |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: NY 012661) | |
| 103TC0700X Psychologist, Clinical (Licence: NY 012661) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: NY 012661) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2011-04-27 |