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General NPI Number Information
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NPI Number | 1720628399
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Entity Type | Individual
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Provider Name | DENNIS FAGUNDO-OJEDA PHD
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Gender | Male
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 1200 WATERS PL STE 310
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City | BRONX
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State | NY
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Zip | 10461-2727
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Country | US
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Telephone | 617-744-8542
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Fax |
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Provider Business Mailing Address
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Address Line | 20 HALLETTS PT APT 1010
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City | ASTORIA
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State | NY
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Zip | 11102-5094
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Country | US
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Telephone | 787-560-4861
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY5000502
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 027485
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License Number State | NY
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