Leland W Petersen, CP - Psychologist in Glen Head, NY

Leland W Petersen, CP is a Psychologist - Clinical based in Glen Head, New York. Leland W Petersen is licensed to practice in New York (license number 05430) and his current practice location is 11 Beechwood Dr, Glen Head, New York. He can be reached at his office (for appointments etc.) via phone at (516) 671-7509.

NPI number for Leland W Petersen is 1790902229 and his current mailing address is 11 Beechwood Dr, Glen Head, New York. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1790902229.

Contact Information

Leland W Petersen, CP
11 Beechwood Dr,
Glen Head, NY 11545-1101
(516) 671-7509
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameLeland W Petersen
GenderMale
SpecialityPsychologist - Clinical
Location11 Beechwood Dr, Glen Head, New York
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1790902229
  • Provider Enumeration Date: 04/19/2007
  • Last Update Date: 10/31/2007

Medical Identifiers

Medical identifiers for Leland W Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1790902229NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 05430 (New York)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Leland W Petersen is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Leland W Petersen, CP
11 Beechwood Dr,
Glen Head, NY 11545-1101

Ph: (516) 671-7509
Leland W Petersen, CP
11 Beechwood Dr,
Glen Head, NY 11545-1101

Ph: (516) 671-7509

Reviews and Comments


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