| Suffolk County Neuropsychological Services, Pllc | |
|
77 Medford Avenue Suite D Patchogue NY 11772-9999 | |
| (631) 366-3369 | |
| (631) 366-2043 |
| Full Name | Suffolk County Neuropsychological Services, Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 77 Medford Avenue, Patchogue, New York |
| Authorized Official Name and Position | Edward John Barnoski (OWNER) |
| Authorized Official Contact | 6313663369 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suffolk County Neuropsychological Services, Pllc 77 Medford Avenue Suite D Patchogue NY 11772-9999 Ph: (631) 366-3369 | Suffolk County Neuropsychological Services, Pllc 77 Medford Avenue Suite D Patchogue NY 11772-9999 Ph: (631) 366-3369 |
| NPI Number | 1861794919 |
|---|---|
| Provider Enumeration Date | 11/23/2010 |
| Last Update Date | 03/11/2011 |
| Medicare PECOS PAC ID | 8123202124 |
|---|---|
| Medicare Enrollment ID | O20110418000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861794919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | 011687-1 (New York) | Primary |
| Provider Name | Edward J Barnoski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932134087 PECOS PAC ID: 9032393038 Enrollment ID: I20110426000427 |
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