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General NPI Number Information
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NPI Number | 1912546953
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Entity Type | Individual
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Provider Name | HENRY SAYRE PSYD
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Gender | Male
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Dates
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Enumeration Date | 12/21/2019
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Last Update Date | 12/21/2019
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Provider Practice Location Address
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Address Line | 91 TOMPKINS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2601
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Country | US
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Telephone | 718-876-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 94 CEDAR LN APT B
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City | HIGHLAND PARK
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State | NJ
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Zip | 08904-2043
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Country | US
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Telephone | 479-806-4330
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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 | P103753
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License Number State | NY
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