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Organization

PEDERSON-KRAG CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MAX BANILIVY (PSYCHOLOGIST)
(631) 920-8164
Entity
Organization

Contact information

Practice address
8 CHESTER CT, HUNTINGTON, NY 11743-5834
(631) 754-1684
Mailing address
8 CHESTER CT, HUNTINGTON, NY 11743-5834
(631) 754-1684

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
41309
NY

Other

Enumeration date
10/23/2015
Last updated
10/23/2015
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