Healthcare Provider Details
I. General information
NPI: 1811207269
Provider Name (Legal Business Name): RONALD JAY HAMER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/19/2010
Last Update Date: 07/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 PINNACLE PL
ALBANY NY
12203-3496
US
IV. Provider business mailing address
1 PINNACLE PL
ALBANY NY
12203-3496
US
V. Phone/Fax
- Phone: 518-689-0244
- Fax: 518-689-0244
- Phone: 518-689-0244
- Fax: 518-689-0244
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | 013634 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: