| North Country Regional Tbi Center | |
|
101 Broad St Beamont 404 Plattsburgh NY 12901-2637 | |
| (518) 564-2155 | |
| Not Available |
| Full Name | North Country Regional Tbi Center |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 101 Broad St, Plattsburgh, New York |
| Authorized Official Name and Position | Michael Edwin Simpson (DIRECTOR OF SPONSORED RESEARCH) |
| Authorized Official Contact | 5185642155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Country Regional Tbi Center 101 Broad St Kehoe 815 Plattsburgh NY 12901-2637 Ph: (518) 564-2155 | North Country Regional Tbi Center 101 Broad St Beamont 404 Plattsburgh NY 12901-2637 Ph: (518) 564-2155 |
| NPI Number | 1982971941 |
|---|---|
| Provider Enumeration Date | 11/18/2011 |
| Last Update Date | 11/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982971941 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 013297 (New York) | Primary |
| 103T00000X | Psychologist | 013297 (New York) | Secondary |
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