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General NPI Number Information
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NPI Number | 1396005716
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Entity Type | Organization
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Legal Business Name | ANDREA GARRY, PSYD, PLLC
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Dates
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Enumeration Date | 05/18/2012
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 80 E HARTSDALE AVE SUITE 105
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City | HARTSDALE
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State | NY
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Zip | 10530-2806
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Country | US
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Telephone | 914-328-0108
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Fax | 914-328-0808
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Provider Business Mailing Address
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Address Line | 80 E HARTSDALE AVE SUITE 105
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City | HARTSDALE
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State | NY
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Zip | 10530-2806
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Country | US
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Telephone | 914-328-0108
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Fax | 914-328-0808
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. ANDREA GARRY
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Credential | PSY.D.
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Telephone | 913-328-0108
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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 | 013724
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License Number State | NY
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