Individual
DR. AMANDA LEA GRODEWALD-ADLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
33 WALT WHITMAN RD STE 240W, HUNTINGTON STATION, NY 11746-3640
(631) 533-2708
Mailing address
1919 MIDDLE COUNTRY RD, SUITE 308, CENTEREACH, NY 11720-5601
(631) 209-5343
(631) 648-7655
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
P77977
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A300066521
MEDICARE PTAN
NY
Enumeration date
10/29/2010
Last updated
09/15/2025
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