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General NPI Number Information
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NPI Number | 1154376630
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Entity Type | Individual
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Provider Name | MARK ELWOOD HAMDI PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 5 WARREN ST SUITE 212
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City | GLENS FALLS
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State | NY
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Zip | 12801-4558
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Country | US
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Telephone | 518-761-9977
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Fax | 518-761-2044
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Provider Business Mailing Address
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Address Line | 2769 COUNTY ROUTE 12
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City | WHITEHALL
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State | NY
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Zip | 12887-2419
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Country | US
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Telephone | 518-499-2696
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Fax | 518-761-2044
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 012146
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License Number State | NY
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