| Jerry Duvinsky Phd Licensed Psychologist Pc | |
|
423 E Main St Ste 3 Endicott NY 13760-6940 | |
| (607) 754-1101 | |
| (607) 754-1107 |
| Full Name | Jerry Duvinsky Phd Licensed Psychologist Pc |
|---|---|
| Speciality | Psychologist |
| Location | 423 E Main St Ste 3, Endicott, New York |
| Authorized Official Name and Position | Jerry Duvinsky (PRESIDENT) |
| Authorized Official Contact | 6077541101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry Duvinsky Phd Licensed Psychologist Pc 423 E Main St Ste 3 Endicott NY 13760-6940 Ph: (607) 754-1101 | Jerry Duvinsky Phd Licensed Psychologist Pc 423 E Main St Ste 3 Endicott NY 13760-6940 Ph: (607) 754-1101 |
| NPI Number | 1043684681 |
|---|---|
| Provider Enumeration Date | 11/19/2015 |
| Last Update Date | 11/19/2015 |
| Medicare PECOS PAC ID | 4587965223 |
|---|---|
| Medicare Enrollment ID | O20160104000151 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043684681 | NPI | - | NPPES |
| 01409512 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 010363 (New York) | Primary |
| Provider Name | Jerry D Duvinsky |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265504211 PECOS PAC ID: 9133318256 Enrollment ID: I20110105000654 |
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