Individual
DR. JONATHAN SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
163 FLEETS COVE RD, HUNTINGTON, NY 11743-1517
(631) 838-3932
Mailing address
163 FLEETS COVE RD, HUNTINGTON, NY 11743-1517
(631) 838-3932
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
013618-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01922201
—
NY
Enumeration date
07/24/2006
Last updated
03/15/2016
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