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General NPI Number Information
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NPI Number | 1639202641
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Entity Type | Organization
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Legal Business Name | ABBE POLSYN PSYD PA
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 123 NW 13TH ST STE 304-07
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City | BOCA RATON
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State | FL
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Zip | 33432-1641
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Country | US
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Telephone | 561-421-6182
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Fax | 561-421-6183
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Provider Business Mailing Address
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Address Line | 123 NW 13TH ST STE 304-07
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City | BOCA RATON
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State | FL
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Zip | 33432-1641
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Country | US
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Telephone | 561-421-6182
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Fax | 561-421-6183
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. ABBE RIVA POLSYN
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Credential | PSYD
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Telephone | 561-421-6182
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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 | PY5744
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License Number State | FL
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