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General NPI Number Information
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NPI Number | 1114233483
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Entity Type | Organization
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Legal Business Name | JUDITH S. GEIZHALS, PH.D.,P.C.
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 114 MIDDLE NECK RD
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-1933
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Country | US
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Telephone | 516-883-6282
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Fax | 516-883-6282
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Provider Business Mailing Address
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Address Line | 114 MIDDLE NECK RD
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City | PORT WASHINGTON
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State | NY
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Zip | 11050-1933
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Country | US
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Telephone | 516-883-6282
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Fax | 516-883-6282
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. JUDITH S GEIZHALS
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Credential | PH.D.
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Telephone | 516-883-6282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 006961-1
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License Number State | NY
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