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Individual

LEE F DECOSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
150 VAN BUREN ST, NEWARK, NY 14513-1238
(315) 331-7741
(315) 331-0566
Mailing address
88 STATE ROUTE 318, PHELPS, NY 14532-9528
(315) 781-1773

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0052791
NY

Other

Enumeration date
03/08/2007
Last updated
07/08/2007
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