Healthcare Provider Details

I. General information

NPI: 1669133757
Provider Name (Legal Business Name): BEDFORD PSYCHOLOGICAL SERVICES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2022
Last Update Date: 01/01/2022
Certification Date: 01/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 N HOLLOW RD
BREWSTER NY
10509-5120
US

IV. Provider business mailing address

11 N HOLLOW RD
BREWSTER NY
10509-5120
US

V. Phone/Fax

Practice location:
  • Phone: 914-419-2678
  • Fax: 845-207-3647
Mailing address:
  • Phone: 914-419-2678
  • Fax: 845-207-3647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. IRWIN LEIBOWITZ
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 914-419-2678