Individual
DR. MARK LAWRENCE DAYBOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
119 FIFTY ACRE RD S, SMITHTOWN, NY 11787-2034
(631) 979-9294
Mailing address
119 FIFTY ACRE RD S, SMITHTOWN, NY 11787-2034
(631) 979-9294
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
009516-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02012224
—
NY
Enumeration date
03/26/2007
Last updated
07/08/2007
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