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NPI 1114303583

NPI 1114303583 : DENISE KAREN ZEIDLER PHD. : NORTH BELLMORE, NY

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General NPI Number Information
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    NPI Number           |    1114303583
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    Entity Type          |    Individual 
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    Provider Name        |    DENISE KAREN ZEIDLER PHD.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/07/2015
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    Last Update Date     |    08/07/2015
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Provider Practice Location Address
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    Address Line         |    979 MARK DR 
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    City                 |    NORTH BELLMORE
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    State                |    NY
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    Zip                  |    11710-1751
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    Country              |    US
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    Telephone            |    516-221-2351
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    979 MARK DR 
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    City                 |    NORTH BELLMORE
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    State                |    NY
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    Zip                  |    11710-1751
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    Country              |    US
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    Telephone            |    516-221-2351
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    009076
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    License Number State |    NY
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