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NPI Code Detail

MEDICARE: DR. WILLIAM KITAY PH.D.

MEDICARE: DR. WILLIAM KITAY 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
1103TC0700XClinical Psychologist009692-1NY

General Provider Information

NPI Number : 1871708479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM KITAY PH.D.
Provider Business Mailing Address
First Line : 30 BRIAN LN
Second Line :
City : JERICHO
State : NY
Zip : 11753
Country : US
Telephone Number : 516-676-2388
Fax Number : 516-759-5259
Provider Business Practice Location Address
First Line : 113 GLEN COVE AVE
Second Line :
City : GLEN COVE
State : NY
Zip : 11542-3438
Country : US
Telephone Number : 516-676-2388
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2007
Last Update Date : 07/08/2007

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