John R. Klindienst Ph. D. Clinical Psychologist P.c. | |
223 Roanoke Avenue Riverhead NY 11901 | |
(631) 727-1563 | |
(361) 369-9423 |
Full Name | John R. Klindienst Ph. D. Clinical Psychologist P.c. |
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Speciality | Psychologist |
Location | 223 Roanoke Avenue, Riverhead, New York |
Authorized Official Name and Position | John R Klindienst (PRESIDENT) |
Authorized Official Contact | 6317271563 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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John R. Klindienst Ph. D. Clinical Psychologist P.c. 223 Roanoke Ave Riverhead NY 11901-2778 Ph: (631) 727-1563 | John R. Klindienst Ph. D. Clinical Psychologist P.c. 223 Roanoke Avenue Riverhead NY 11901 Ph: (631) 727-1563 |
NPI Number | 1821242876 |
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Provider Enumeration Date | 11/04/2008 |
Last Update Date | 11/04/2008 |
Medicare PECOS PAC ID | 0345309100 |
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Medicare Enrollment ID | O20081107000474 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821242876 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 007012 (New York) | Primary |
Provider Name | John R Klindienst |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1952466682 PECOS PAC ID: 7719046572 Enrollment ID: I20081107000460 |
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