| Myling Sumanti Psychology Pc | |
|
150 Motor Pkwy Ste 401 Hauppauge NY 11788-5108 | |
| (888) 786-2684 | |
| (888) 786-2684 |
| Full Name | Myling Sumanti Psychology Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 150 Motor Pkwy Ste 401, Hauppauge, New York |
| Authorized Official Name and Position | Myling Sumanti (PRESIDENT) |
| Authorized Official Contact | 5133683722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Myling Sumanti Psychology Pc 150 Motor Pkwy Ste 401 Hauppauge NY 11788-5108 Ph: (513) 368-3722 | Myling Sumanti Psychology Pc 150 Motor Pkwy Ste 401 Hauppauge NY 11788-5108 Ph: (888) 786-2684 |
| NPI Number | 1902432073 |
|---|---|
| Provider Enumeration Date | 03/20/2020 |
| Last Update Date | 08/28/2020 |
| Certification Date | 08/24/2020 |
| Medicare PECOS PAC ID | 5698104016 |
|---|---|
| Medicare Enrollment ID | O20200407001083 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902432073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Myling Sumanti |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699873794 PECOS PAC ID: 3072693100 Enrollment ID: I20080102000415 |
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