Individual
LINDA JOYCE BUCARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
646 MAIN ST, PORT JEFFERSON, NY 11777
(631) 928-6228
Mailing address
1 NORTH HAMPTON AVE, MILLER PLACE, NY 11764
(631) 928-6228
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
11051
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038326
EMPIRE VALUE OPTIONS
NY
01
—
209679
UNITED BEHAVIOR HEALTH
NY
Enumeration date
01/22/2007
Last updated
07/08/2007
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