=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639486079
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PSYCHOLOGICAL HEALTH CARE OF ISLIP, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/07/2010
-----------------------------------------------------
Last Update Date | 09/07/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 S MAIN ST SUITE 206
-----------------------------------------------------
City | SAYVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11782-3100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-277-4080
-----------------------------------------------------
Fax | 631-288-1115
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 712
-----------------------------------------------------
City | SAYVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11782-0712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-277-4080
-----------------------------------------------------
Fax | 631-288-1115
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT / PSYCHOLOGIST
-----------------------------------------------------
Name | DR. MARGARET PATRICIA MCALEER
-----------------------------------------------------
Credential | PH.D
-----------------------------------------------------
Telephone | 631-277-4080
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 011355
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------