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NPI Code Detail

MEDICARE: DR. DENNIS WILLIAM MEADE PHD

MEDICARE: DR. DENNIS WILLIAM MEADE PHD
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
1103TC0700XClinical Psychologist007361-4NY

General Provider Information

NPI Number : 1609144567
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DENNIS WILLIAM MEADE PHD
Provider Business Mailing Address
First Line : 100 CAMPUS DR
Second Line :
City : PORT WASHINGTON
State : NY
Zip : 11050-3719
Country : US
Telephone Number : 516-767-5819
Fax Number :
Provider Business Practice Location Address
First Line : 100 CAMPUS DR
Second Line :
City : PORT WASHINGTON
State : NY
Zip : 11050-3719
Country : US
Telephone Number : 516-767-5819
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2011
Last Update Date : 12/07/2011

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