Healthcare Provider Details

I. General information

NPI: 1730211277
Provider Name (Legal Business Name): DAVID JEFFREY APOTHEKER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2007
Last Update Date: 12/24/2019
Certification Date: 12/24/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

297 KNOLLWOOD RD STE 302
WHITE PLAINS NY
10607-1849
US

IV. Provider business mailing address

1 BERGHOLZ DR
NEW ROCHELLE NY
10801-2318
US

V. Phone/Fax

Practice location:
  • Phone: 914-320-9031
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number011382-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number011382-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number011382-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number011382-1
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number011382-1
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number011382-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: