MEDICARE: DR. JUSTIN LEE DAINER-BEST 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
1	103TC0700X	Clinical Psychologist	023811	NY

General Provider Information

NPI Number	:	1790360295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN LEE DAINER-BEST PHD

Provider Business Mailing Address
First Line	:	176 BECKER HILL RD
Second Line	:
City	:	MILAN
State	:	NY
Zip	:	12571-4150
Country	:	US
Telephone Number	:	845-320-2188
Fax Number	:

Provider Business Practice Location Address
First Line	:	176 BECKER HILL RD
Second Line	:
City	:	MILAN
State	:	NY
Zip	:	12571-4150
Country	:	US
Telephone Number	:	845-320-2188
Fax Number	:

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

Provider Enumeration Date	:	03/16/2021
Last Update Date	:	08/10/2021

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