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NPI Code Detail

MEDICARE: DR. WILLY HENIK PH.D.

MEDICARE:  DR. WILLY  HENIK  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist1035NJ

General Provider Information

NPI Number : 1003966409
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLY HENIK PH.D.
Provider Business Mailing Address
First Line : 7000 KENNEDY BLVD E
Second Line : 1-50 B
City : GUTTENBERG
State : NJ
Zip : 07093-4818
Country : US
Telephone Number : 201-453-8744
Fax Number :
Provider Business Practice Location Address
First Line : 7000 KENNEDY BLVD E
Second Line : 1-50 B
City : GUTTENBERG
State : NJ
Zip : 07093-4818
Country : US
Telephone Number : 201-453-8744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 07/08/2007

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