Individual
DR. SAMUEL JEANNITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
118-35 QUEENS BLVD., SUITE 400, QUEENS, NY 11375
(347) 460-6048
Mailing address
17832 145TH RD, JAMAICA, NY 11434-5033
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
022015-1
NY
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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