Individual
DR. KEVIN J WORGUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
29 BARSTOW RD, SUITE 102, GREAT NECK, NY 11021-2209
(516) 466-2017
(718) 631-9801
Mailing address
29 BARSTOW RD, SUITE 102, GREAT NECK, NY 11021-2209
(516) 466-2017
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
010112
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0067427
GHI-BMP
NY
01
—
144667
VALUE OPTIONS
NY
Enumeration date
09/29/2006
Last updated
07/08/2007
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