Organization
NORTH FORK NEUROPSYCHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CELINE MARIE PAILLOT PHD (OWNER AND FOUNDER)
(631) 512-2232
Entity
Organization
Contact information
Practice address
633 ROANOKE AVE, RIVERHEAD, NY 11901-2727
(631) 512-2232
(480) 247-4658
Mailing address
633 ROANOKE AVE, RIVERHEAD, NY 11901-2727
(631) 512-2232
(480) 247-4658
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
019026-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03319817
—
NY
Enumeration date
06/24/2014
Last updated
06/24/2014
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