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NPI 1881163616

NPI 1881163616 : BARBARA SUSAN WELIKY PSY.D. : WILLISTON PARK, NY

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General NPI Number Information
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    NPI Number           |    1881163616
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    Entity Type          |    Individual 
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    Provider Name        |    BARBARA SUSAN WELIKY PSY.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/22/2018
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    Last Update Date     |    11/22/2018
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Provider Practice Location Address
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    Address Line         |    32 HAWTHORNE ST 
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    City                 |    WILLISTON PARK
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    State                |    NY
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    Zip                  |    11596-1706
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    Country              |    US
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    Telephone            |    917-414-2659
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    32 HAWTHORNE ST 
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    City                 |    WILLISTON PARK
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    State                |    NY
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    Zip                  |    11596-1706
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    Country              |    US
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    Telephone            |    917-414-2659
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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        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    011296
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    License Number State |    NY
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