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Organization

DENNIS M HENDERSON PSYCHOLOGICAL SERVICES PC

Active
Parent organization
DENNIS M HENDERSON PSYCHOLOGICAL SERVICES PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
DENNIS M HENDERSON PSYCHOLOGICAL SERVICES PC
Authorized official
DR. DENNIS MALCOLM HENDERSON PHD (PRESIDENT/CEO)
(631) 368-8502
Entity
Organization

Contact information

Practice address
12 GILDARE DR, EAST NORTHPORT, NY 11731-3223
(631) 368-8502
(631) 368-8502
Mailing address
12 GILDARE DR, EAST NORTHPORT, NY 11731-3223
(631) 368-8502
(631) 368-8502

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0117921
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01660731
NY
01
1639287758
NPI
NY
Enumeration date
08/08/2007
Last updated
08/08/2007
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