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General NPI Number Information
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NPI Number | 1275917650
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Entity Type | Organization
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Legal Business Name | NEW HARTFORD PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 44 OXFORD RD
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City | NEW HARTFORD
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State | NY
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Zip | 13413-2660
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Country | US
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Telephone | 315-223-8889
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Fax |
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Provider Business Mailing Address
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Address Line | 32 PLYMOUTH AVE
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City | WHITESBORO
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State | NY
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Zip | 13492-2921
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Country | US
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Telephone | 315-736-3598
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ANDREW KINNEY
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Credential | PH.D.
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Telephone | 315-223-8889
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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 | 012796
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License Number State | NY
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