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Organization
NORTH FORK NEUROPSYCHOLOGY
Active
Organization
NORTH FORK NEUROPSYCHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CELINE MARIE PAILLOT PH.D. (FOUNDER AND OWNER)
(631) 875-2748
Entity
Organization
Contact information
Practice address
12 PLATINUM CT, MEDFORD, NY 11763-2247
(631) 875-2748
(480) 247-4658
Mailing address
12 PLATINUM CT, MEDFORD, NY 11763-2247
(631) 875-2748
(480) 247-4658
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Enumeration date
01/20/2012
Last updated
01/20/2012
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