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General NPI Number Information
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NPI Number | 1982613162
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Entity Type | Individual
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Provider Name | ROGER SAINT-LAURENT PSYD
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 08/27/2012
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Provider Practice Location Address
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Address Line | 27 WEST 86TH STREET SUITE 1D
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City | NEW YORK
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State | NY
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Zip | 10024
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Country | US
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Telephone | 212-866-1128
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Fax | 914-944-0035
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Provider Business Mailing Address
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Address Line | 792 SLEEPY HOLLOW ROAD
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City | BRIARCLIFF MANOR
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State | NY
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Zip | 10510-2525
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Country | US
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Telephone | 914-944-0035
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Fax | 914-944-0035
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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 | 012931
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License Number State | NY
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