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General NPI Number Information
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NPI Number | 1356563431
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Entity Type | Organization
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Legal Business Name | CHERYL S CHITAYAT PSY D PC
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 02/09/2018
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Provider Practice Location Address
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Address Line | 358 VETERANS MEMORIAL HWY. SUITE 12
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City | COMMACK
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State | NY
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Zip | 11725-4332
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Country | US
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Telephone | 631-864-5535
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Fax |
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Provider Business Mailing Address
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Address Line | 358 VETERANS MEMORIAL HWY. SUITE 12
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City | COMMACK
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State | NY
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Zip | 11725-4332
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Country | US
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Telephone | 631-864-5535
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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. CHERYL S. CHITAYAT
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Credential | PSY.D.
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Telephone | 631-864-5535
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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 | 009723
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 009723
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 009723
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License Number State | NY
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