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Organization
SUPPORTIVE PSYCHOLOGICAL SERVICES OF LONG ISLAND, P.C.
Active
Organization
SUPPORTIVE PSYCHOLOGICAL SERVICES OF LONG ISLAND, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDA GANZENMULLER PSY.D. (PRESIDENT)
(631) 252-1221
Entity
Organization
Contact information
Practice address
6500 JERICHO TPKE, COMMACK, NY 11725-2909
(631) 252-1221
Mailing address
PO BOX 1226, COMMACK, NY 11725-0900
(631) 252-1221
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
04/28/2017
Last updated
04/28/2017
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