Healthcare Provider Details

I. General information

NPI: 1609996685
Provider Name (Legal Business Name): GREGORY ALLEN HINRICHSEN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 10/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W 16TH ST 5B
NEW YORK NY
10011-6165
US

IV. Provider business mailing address

200 W 16TH ST 5B
NEW YORK NY
10011-6165
US

V. Phone/Fax

Practice location:
  • Phone: 212-989-7239
  • Fax:
Mailing address:
  • Phone: 212-989-7239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number007772-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: