| Michael L Nissnbaum, Ph.d., Psychologist, P.c. | |
|
4 Coed Ln Stony Brook NY 11790-2704 | |
| (631) 737-9500 | |
| (631) 737-9512 |
| Full Name | Michael L Nissnbaum, Ph.d., Psychologist, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 4 Coed Ln, Stony Brook, New York |
| Authorized Official Name and Position | Michael Leonard Nissenbaum (PRESIDENT) |
| Authorized Official Contact | 6317379500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael L Nissnbaum, Ph.d., Psychologist, P.c. 4 Coed Ln Stony Brook NY 11790-2704 Ph: (631) 737-9500 | Michael L Nissnbaum, Ph.d., Psychologist, P.c. 4 Coed Ln Stony Brook NY 11790-2704 Ph: (631) 737-9500 |
| NPI Number | 1205009511 |
|---|---|
| Provider Enumeration Date | 04/08/2008 |
| Last Update Date | 07/01/2008 |
| Medicare PECOS PAC ID | 2062591902 |
|---|---|
| Medicare Enrollment ID | O20080505000295 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205009511 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 010232 (New York) | Primary |
| Provider Name | Michael L Nissenbaum |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174546725 PECOS PAC ID: 2264336296 Enrollment ID: I20031121000443 |
George G. Fairey Md Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 N Country Rd Ste 2a, Stony Brook, NY 11790 Phone: 631-689-5155 | |
John G. Cottone, Psychologist, Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1099 N Country Rd, Suite L, Stony Brook, NY 11790 Phone: 631-941-2210 Fax: 631-941-2210 | |
Department Of Neurology Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: Nicolls Road, Hsc T12 Room 020 Stony Brook University Hospital, Stony Brook, NY 11794 Phone: 631-444-2599 Fax: 631-444-4743 | |
Corina Segal Mental Health Counseling, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2500 Nesconset Hwy Bldg 4b, Stony Brook, NY 11790 Phone: 631-903-1087 | |
Ryan L Clements Psy.d. Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1099 N Country Rd, Unit L, Stony Brook, NY 11790 Phone: 631-941-2210 | |
Brett M. Liquori, Licensed Psychologist, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12 Westwood Ave, Stony Brook, NY 11790 Phone: 631-444-5354 Fax: 631-444-5354 |