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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