MEDICARE: DR. ROBERT J DRAGO PH.D.

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	103T00000X	Psychologist	008895	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	112920207	OTHER	NY	NEW YORK STATE LICENSE

General Provider Information

NPI Number	:	1265598338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT J DRAGO PH.D.

Provider Business Mailing Address
First Line	:	75 PROSPECT ST STE 208
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-3310
Country	:	US
Telephone Number	:	516-739-2412
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 PROSPECT ST STE 208
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-3310
Country	:	US
Telephone Number	:	516-739-2412
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2006
Last Update Date	:	11/05/2023

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Directions to “ DR. ROBERT J DRAGO PH.D.” Practice Location

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