Healthcare Provider Details

I. General information

NPI: 1174687164
Provider Name (Legal Business Name): DAVID SPEIGHTS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 E 55TH ST SUITE 7C
NEW YORK NY
10022-4030
US

IV. Provider business mailing address

141 E 55TH ST SUITE 7C
NEW YORK NY
10022-4030
US

V. Phone/Fax

Practice location:
  • Phone: 212-308-0313
  • Fax: 516-921-8707
Mailing address:
  • Phone: 212-308-0313
  • Fax: 516-921-8707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number7124
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: