| Dallet Psychological Services Pc | |
|
821 Newburg Ave Valley Stream NY 11581-3107 | |
| (917) 657-0290 | |
| Not Available |
| Full Name | Dallet Psychological Services Pc |
|---|---|
| Speciality | Psychologist |
| Location | 821 Newburg Ave, Valley Stream, New York |
| Authorized Official Name and Position | Yuliya Vaynrub (MANAGER) |
| Authorized Official Contact | 9176570290 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dallet Psychological Services Pc 821 Newburg Ave Valley Stream NY 11581-3107 Ph: (917) 657-0290 | Dallet Psychological Services Pc 821 Newburg Ave Valley Stream NY 11581-3107 Ph: (917) 657-0290 |
| NPI Number | 1386331791 |
|---|---|
| Provider Enumeration Date | 04/18/2023 |
| Last Update Date | 04/18/2023 |
| Certification Date | 04/18/2023 |
| Medicare PECOS PAC ID | 9537527882 |
|---|---|
| Medicare Enrollment ID | O20230620001641 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386331791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Grigory Orenbakh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366533754 PECOS PAC ID: 5193778488 Enrollment ID: I20050228000041 |
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