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Individual

DR. LINDA GANZENMULLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
66 HARNED RD, COMMACK, NY 11725-3527
(631) 543-8577
(631) 543-8573
Mailing address
39 PAWNEE DR, COMMACK, NY 11725-4225

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
018628-1
NY

Other

Enumeration date
12/29/2006
Last updated
12/13/2010
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