Individual
DR. ETTALEE SAMEK PASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
29 MANOR RD, SMITHTOWN, NY 11787-2714
(631) 265-8873
(631) 751-5287
Mailing address
29 MANOR RD, SMITHTOWN, NY 11787-2752
(631) 265-8873
(631) 751-5287
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
011597
NY
Other
Enumeration date
06/14/2006
Last updated
02/07/2010
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