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General NPI Number Information
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NPI Number | 1831252568
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Entity Type | Individual
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Provider Name | CRAIG KENNETH POLITE PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 155 E 29TH ST SUITE #27H
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City | NEW YORK
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State | NY
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Zip | 10016-8173
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Country | US
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Telephone | 917-887-9420
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Fax | 203-221-8424
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Provider Business Mailing Address
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Address Line | 34 HIGHLAND RD
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City | WESTPORT
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State | CT
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Zip | 06880-2844
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Country | US
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Telephone | 203-221-8424
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Fax | 203-221-8424
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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 | 005104
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License Number State | NY
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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 | 3024
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License Number State | NC
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