L.w. Petersen, Psychologist, P.c. | |
11 Beechwood Dr Glen Head NY 11545-1101 | |
(516) 671-7509 | |
Not Available |
Full Name | L.w. Petersen, Psychologist, P.c. |
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Speciality | Psychologist - Clinical |
Location | 11 Beechwood Dr, Glen Head, New York |
Authorized Official Name and Position | Leland Walter Petersen (PRESIDENT) |
Authorized Official Contact | 5166717509 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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L.w. Petersen, Psychologist, P.c. 11 Beechwood Dr Glen Head NY 11545-1101 Ph: (516) 671-7509 | L.w. Petersen, Psychologist, P.c. 11 Beechwood Dr Glen Head NY 11545-1101 Ph: (516) 671-7509 |
NPI Number | 1083831408 |
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Provider Enumeration Date | 04/19/2007 |
Last Update Date | 06/17/2008 |
Identifier | Type | State | Issuer |
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1083831408 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 05430 (New York) | Primary |
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