Individual
GERALD ROBERT YAGODA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
9 N MAIN ST, EAST HAMPTON, NY 11937-2632
(631) 329-0680
(631) 267-6467
Mailing address
9 N MAIN ST, EAST HAMPTON, NY 11937-2632
(631) 329-0680
(631) 267-6467
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4132
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137695
VALUE OPTIONS
NY
01
—
6894605
GHI
NY
Enumeration date
04/19/2007
Last updated
07/08/2007
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