| Leland W. Petersen, Psychologist, P.c. | |
|
11 Beechwood Dr Glen Head NY 11545-1101 | |
| (516) 671-7509 | |
| Not Available |
| Full Name | Leland W. Petersen, Psychologist, P.c. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 11 Beechwood Dr, Glen Head, New York |
| Authorized Official Name and Position | Leland Walter Petersen (PRESIDENT) |
| Authorized Official Contact | 5166717509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leland W. Petersen, Psychologist, P.c. 11 Beechwood Dr Glen Head NY 11545-1101 Ph: (516) 671-7509 | Leland W. Petersen, Psychologist, P.c. 11 Beechwood Dr Glen Head NY 11545-1101 Ph: (516) 671-7509 |
| NPI Number | 1083831408 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083831408 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 05430 (New York) | Primary |
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