Organization
EAST END KIDS PSY, SLP, OT & PT SERV. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN SICILIAN PH.D. (EXECUTIVE DIRECTOR / PSYCHOLOGIST)
(631) 267-2900
Entity
Organization
Contact information
Practice address
502 N SEA RD, SOUTHAMPTON, NY 11968-2012
(631) 267-2900
(631) 267-2950
Mailing address
502 N SEA RD, SOUTHAMPTON, NY 11968-2012
(631) 267-2900
(631) 267-2950
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
009036
NY
Other
Enumeration date
03/30/2011
Last updated
03/30/2011
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