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General NPI Number Information
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NPI Number | 1639452337
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Entity Type | Organization
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Legal Business Name | ANDREW VAUGHAN, PSYHCHOLOGIST, PH.D., P.C.
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Dates
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Enumeration Date | 09/20/2011
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Last Update Date | 09/20/2011
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Provider Practice Location Address
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Address Line | 3 GREENHILLS RD
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-3905
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Country | US
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Telephone | 631-239-1108
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Fax |
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Provider Business Mailing Address
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Address Line | 3 GREENHILLS RD
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-3905
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Country | US
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Telephone | 631-239-1108
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANDREW E. VAUGHAN
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Credential | PH.D,
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Telephone | 631-239-1108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 012962-1
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License Number State | NY
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