MEDICARE: GINDES PSYCHOLOGICAL PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	10301	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013070341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GINDES PSYCHOLOGICAL PLLC

Provider Business Mailing Address
First Line	:	10 CANTERBERRY CT
Second Line	:
City	:	HOPEWELL JUNCTION
State	:	NY
Zip	:	12533-5261
Country	:	US
Telephone Number	:	845-227-7661
Fax Number	:	845-227-7661

Provider Business Practice Location Address
First Line	:	46 FOSTER RD
Second Line	:	RAMONA PARK STE 3
City	:	HOPEWELL JCT
State	:	NY
Zip	:	12533-6112
Country	:	US
Telephone Number	:	845-227-7661
Fax Number	:	845-227-7661

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. ALEX GINDES
Credential	:	PSY. D
Telephone Number	:	845-227-7661

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	05/28/2008

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