MEDICARE: DR. PATRICIA A. HANNIGAN-WHITE PSY.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	103TC0700X	Clinical Psychologist	11325	NY

General Provider Information

NPI Number	:	1528197217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA A. HANNIGAN-WHITE PSY.D

Provider Business Mailing Address
First Line	:	45 PLAZA ST W
Second Line	:	SUITE 1B
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3952
Country	:	US
Telephone Number	:	781-399-7230
Fax Number	:	718-399-7230

Provider Business Practice Location Address
First Line	:	45 PLAZA ST W
Second Line	:	SUITE 1B
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3952
Country	:	US
Telephone Number	:	781-399-7230
Fax Number	:	718-399-7230

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/08/2007

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