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General NPI Number Information
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NPI Number | 1407942543
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Entity Type | Individual
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Provider Name | THOMAS MENAKER PHD
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 41 WEST 94TH STREET
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City | NEW YORK
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State | NY
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Zip | 10025
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Country | US
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Telephone | 212-222-0860
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Fax |
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Provider Business Mailing Address
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Address Line | 27 HIGH TOR ROAD
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City | NEW CITY
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State | NY
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Zip | 10956-5702
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Country | US
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Telephone | 845-634-3283
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Fax | 845-639-9276
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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 | 003298
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License Number State | NY
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