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General NPI Number Information
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NPI Number | 1669603700
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Entity Type | Organization
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Legal Business Name | JOSPEH W NEWIRTH PHD PC PSYCHOLOGIST
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 20 CANTERBURY RD
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City | GREAT NECK
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State | NY
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Zip | 11021-2122
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Country | US
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Telephone | 516-504-0126
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Fax |
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Provider Business Mailing Address
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Address Line | 20 CANTERBURY RD
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City | GREAT NECK
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State | NY
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Zip | 11021-2122
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Country | US
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Telephone | 516-504-0126
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH W NEWIRTH
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Credential | PH.D.
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Telephone | 516-504-0126
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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 | 003889-1
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License Number State | NY
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