| Christine Coolidge Rn Cs Phd Pc | |
|
186 W Montauk Hwy D 1 Hampton Bays NY 11946 | |
| (631) 728-2000 | |
| Not Available |
| Full Name | Christine Coolidge Rn Cs Phd Pc |
|---|---|
| Speciality | Psychologist |
| Location | 186 W Montauk Hwy D 1, Hampton Bays, New York |
| Authorized Official Name and Position | Christine Coolidge (PRESIDENT) |
| Authorized Official Contact | 6317282000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christine Coolidge Rn Cs Phd Pc 18 Duckwood La Hampton Bays NY 11946 Ph: (631) 728-2000 | Christine Coolidge Rn Cs Phd Pc 186 W Montauk Hwy D 1 Hampton Bays NY 11946 Ph: (631) 728-2000 |
| NPI Number | 1932272309 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 07/20/2007 |
| Medicare PECOS PAC ID | 8820311970 |
|---|---|
| Medicare Enrollment ID | O20141223000400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932272309 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 0148401 (New York) | Primary |
| 364S00000X | Clinical Nurse Specialist | 2428621 (New York) | Secondary |
| Provider Name | Christine Coolidge |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255525549 PECOS PAC ID: 7810189859 Enrollment ID: I20150429001000 |
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