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General NPI Number Information
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NPI Number | 1649595406
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Entity Type | Organization
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Legal Business Name | EMILY R. LANTZ PSYD PC
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 200 S BROADWAY SUITE 201
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City | TARRYTOWN
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State | NY
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Zip | 10591-4500
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Country | US
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Telephone | 914-860-6608
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Fax | 914-502-0120
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Provider Business Mailing Address
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Address Line | 200 S BROADWAY SUITE 201
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City | TARRYTOWN
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State | NY
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Zip | 10591-4500
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Country | US
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Telephone | 914-860-6608
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Fax | 914-502-0120
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Authorized Official
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Title or Position | PRESIDENT
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Name | EMILY R LANTZ
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Credential | PSY.D.
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Telephone | 914-860-6608
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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