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NPI Code Detail

MEDICARE: DR. KERRY M CANNITY PHD

MEDICARE: DR. KERRY M CANNITY 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 Psychologist022849NY

General Provider Information

NPI Number : 1861827818
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KERRY M CANNITY PHD
Provider Business Mailing Address
First Line : 155 E 99TH ST APT 3
Second Line :
City : NEW YORK
State : NY
Zip : 10029-6772
Country : US
Telephone Number : 919-601-7841
Fax Number :
Provider Business Practice Location Address
First Line : 3 TIMES SQ FL 10
Second Line :
City : NEW YORK
State : NY
Zip : 10036-6564
Country : US
Telephone Number : 646-537-6763
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2013
Last Update Date : 01/09/2024

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Directions to “ DR. KERRY M CANNITY PHD” Practice Location

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