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General NPI Number Information
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NPI Number | 1306202056
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Entity Type | Organization
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Legal Business Name | MIND CONNECTIONS INC
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Dates
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Enumeration Date | 01/11/2016
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Last Update Date | 01/11/2016
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Provider Practice Location Address
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Address Line | 14220 FRANKLIN AVE
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City | FLUSHING
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State | NY
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Zip | 11355-2640
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Country | US
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Telephone | 347-542-8226
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Fax |
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Provider Business Mailing Address
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Address Line | 4108 PARSONS BLVD 2D
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City | FLUSHING
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State | NY
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Zip | 11355-1965
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JUNHONG CAO
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Credential | PH.D.
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Telephone | 347-542-8226
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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 | 018386
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License Number State | NY
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