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General NPI Number Information
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NPI Number | 1659374494
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Entity Type | Individual
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Provider Name | HENRY MICHAEL KOEGEL PHD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 412 6TH AVE STE 612
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City | NEW YORK
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State | NY
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Zip | 10011-8409
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Country | US
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Telephone | 212-674-3998
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Fax | 212-674-3998
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Provider Business Mailing Address
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Address Line | 191 WILLOUGHBY ST APT 3G
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City | BROOKLYN
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State | NY
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Zip | 11201-5441
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Country | US
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Telephone | 718-222-8799
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 013652
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License Number State | NY
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