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General NPI Number Information
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NPI Number | 1114234853
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL EVALUATIONS AND CONSULTING, LLC
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Dates
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Enumeration Date | 09/01/2010
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Last Update Date | 09/01/2010
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Provider Practice Location Address
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Address Line | 66 MAIN ST
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City | BEDFORD HILLS
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State | NY
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Zip | 10507-1800
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Country | US
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Telephone | 914-244-0755
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Fax |
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Provider Business Mailing Address
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Address Line | 66 MAIN ST
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City | BEDFORD HILLS
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State | NY
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Zip | 10507-1800
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Country | US
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Telephone | 914-244-0755
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD PETER DEBENEDETTO
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Credential | PH.D.
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Telephone | 914-244-0755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 008548-1
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License Number State | NY
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