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General NPI Number Information
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NPI Number | 1801172192
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Entity Type | Organization
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Legal Business Name | STRATEGIC NEUROPSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 10/31/2011
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Last Update Date | 10/31/2011
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Provider Practice Location Address
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Address Line | 1651 3RD AVE RM 201
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City | NEW YORK
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State | NY
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Zip | 10128-3679
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Country | US
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Telephone | 201-344-1999
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Fax |
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Provider Business Mailing Address
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Address Line | 40 WATERSIDE PLZ APT 12L
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City | NEW YORK
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State | NY
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Zip | 10010-2631
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Country | US
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Telephone | 917-340-1612
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA LEAH SACKS
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Credential | PH.D.
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Telephone | 201-344-1999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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