Healthcare Provider Details

I. General information

NPI: 1720080260
Provider Name (Legal Business Name): JUNE GAYLE BECK PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

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

III. Provider practice location address

8610 TRANSIT RD SUITE 2
EAST AMHERST NY
14051-2608
US

IV. Provider business mailing address

8610 TRANSIT RD SUITE 2
EAST AMHERST NY
14051-2608
US

V. Phone/Fax

Practice location:
  • Phone: 716-645-3650
  • Fax: 716-645-3801
Mailing address:
  • Phone: 716-645-3650
  • Fax: 716-645-3801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number011918
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: