Healthcare Provider Details

I. General information

NPI: 1093637373
Provider Name (Legal Business Name): JOSETTE TUGANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 W MAIN ST
PATCHOGUE NY
11772-3012
US

IV. Provider business mailing address

440 W MAIN ST
PATCHOGUE NY
11772-3012
US

V. Phone/Fax

Practice location:
  • Phone: 631-438-1220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number028356
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: