| Dr. Fred Krellenstein, Psychologist, P.c. | |
|
8 Holly Dr Syosset NY 11791-5718 | |
| (516) 921-3943 | |
| (516) 682-8210 |
| Full Name | Dr. Fred Krellenstein, Psychologist, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 8 Holly Dr, Syosset, New York |
| Authorized Official Name and Position | Fred Krellenstein (PRESIDENT) |
| Authorized Official Contact | 5169213943 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Fred Krellenstein, Psychologist, P.c. 8 Holly Dr Syosset NY 11791-5718 Ph: (516) 921-3943 | Dr. Fred Krellenstein, Psychologist, P.c. 8 Holly Dr Syosset NY 11791-5718 Ph: (516) 921-3943 |
| NPI Number | 1215293709 |
|---|---|
| Provider Enumeration Date | 04/09/2012 |
| Last Update Date | 07/17/2013 |
| Medicare PECOS PAC ID | 7113169749 |
|---|---|
| Medicare Enrollment ID | O20130812000508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215293709 | NPI | - | NPPES |
| 00872835 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Fred B Krellenstein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538258058 PECOS PAC ID: 0749422376 Enrollment ID: I20130812000540 |
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