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General NPI Number Information
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NPI Number | 1609935444
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Entity Type | Organization
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Legal Business Name | ADULT CARE PSYCHOLOGY SERVICES, PLLC
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 13711 73RD TER
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City | FLUSHING
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State | NY
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Zip | 11367-2303
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Country | US
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Telephone | 718-575-3510
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Fax | 718-575-0391
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Provider Business Mailing Address
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Address Line | 13711 73RD TER
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City | FLUSHING
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State | NY
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Zip | 11367-2303
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Country | US
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Telephone | 718-575-3510
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Fax | 718-575-0391
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. MARK KUTNER
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Credential | PH.D.
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Telephone | 718-575-3510
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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 |
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License Number State |
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