Healthcare Provider Details

I. General information

NPI: 1487705943
Provider Name (Legal Business Name): LEONARD R. EPSTEIN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 08/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 41ST AVE
EUGENE OR
97405-3406
US

IV. Provider business mailing address

200 E 41ST AVE
EUGENE OR
97405-3406
US

V. Phone/Fax

Practice location:
  • Phone: 914-844-9584
  • Fax:
Mailing address:
  • Phone: 914-844-9584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number006938-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: