Healthcare Provider Details

I. General information

NPI: 1407851686
Provider Name (Legal Business Name): ALAN DAVID KAPLAN PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 ANNANDALE DR
COMMACK NY
11725-1745
US

IV. Provider business mailing address

40 ANNANDALE DR
COMMACK NY
11725-1745
US

V. Phone/Fax

Practice location:
  • Phone: 631-544-4825
  • Fax: 631-544-4825
Mailing address:
  • Phone: 631-544-4825
  • Fax: 631-544-4825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8601-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: