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Individual

DR. KENNETH MARK SOSSIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1893 STEWART AVE, NEW HYDE PARK, NY 11040-1623
(516) 326-2401
(516) 326-6973
Mailing address
1893 STEWART AVE, NEW HYDE PARK, NY 11040-1623
(516) 326-2401

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
007858
NY
103TC0700X
Clinical Psychologist
007858
NY
103TC2200X
Clinical Child & Adolescent Psychologist
103TP0814X
Psychoanalysis Psychologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007858
NYS LICENSED PSYCHOLOGIST
NY
Enumeration date
08/04/2017
Last updated
08/04/2017
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