Individual
DR. FRED RONALD WAXENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3001 HEWLETT AVE, MERRICK, NY 11566-5312
(516) 987-2351
Mailing address
3001 HEWLETT AVE, MERRICK, NY 11566-5312
(516) 987-2351
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
0006472
NY
Other
Enumeration date
10/16/2020
Last updated
10/22/2020
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