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General NPI Number Information
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NPI Number | 1598925687
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Entity Type | Organization
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Legal Business Name | CONNIE K MCNEIL, CLINICAL PSYCHOLOGIST PLLC
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 01/29/2011
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Provider Practice Location Address
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Address Line | 455 CENTRAL PARK AVE SUITE 202
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City | SCARSDALE
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State | NY
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Zip | 10583-1060
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Country | US
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Telephone | 914-472-3711
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Fax |
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Provider Business Mailing Address
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Address Line | 455 CENTRAL PARK AVE SUITE 202
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City | SCARSDALE
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State | NY
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Zip | 10583-1060
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Country | US
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Telephone | 914-472-3711
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Fax | 914-723-7637
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. CONNIE K MCNEIL
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Credential | P.HD.
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Telephone | 914-472-3711
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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 | 014435-3
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License Number State | NY
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