Healthcare Provider Details

I. General information

NPI: 1487841417
Provider Name (Legal Business Name): PATRICIA A. CUMMINGS PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 02/11/2020
Certification Date: 02/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 BROADWAY
PLEASANTVILLE NY
10570-2346
US

IV. Provider business mailing address

1075 BROADWAY
PLEASANTVILLE NY
10570-2346
US

V. Phone/Fax

Practice location:
  • Phone: 914-773-6127
  • Fax: 415-334-5712
Mailing address:
  • Phone: 415-452-2200
  • Fax: 415-334-5712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number022698
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: