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General NPI Number Information
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NPI Number | 1881061703
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Entity Type | Individual
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Provider Name | CHRISTOPHER KEARNEY PSY.D
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Gender | Male
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Dates
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Enumeration Date | 08/26/2015
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Last Update Date | 08/26/2015
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Provider Practice Location Address
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Address Line | 290 MAIN ST
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City | EAST SETAUKET
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State | NY
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Zip | 11733-2871
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Country | US
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Telephone | 631-740-7078
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Fax |
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Provider Business Mailing Address
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Address Line | 38 AUTUMN DR
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City | MOUNT SINAI
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State | NY
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Zip | 11766-2303
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Country | US
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Telephone | 631-740-7078
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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 | 020692
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License Number State | NY
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