Individual
DR. GREGORY VIKINGSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
7529 263RD ST, GLEN OAKS, NY 11004-1150
(718) 470-3142
Mailing address
7529 263RD ST, GLEN OAKS, NY 11004-1150
(718) 470-3142
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
68021286
NY
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
68021286
NY
Other
Enumeration date
08/30/2015
Last updated
02/29/2020
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