Organization
FIRST LIGHT PSYCHOLOGICAL SERVICES, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THERESA IRENE DESANTIS PH.D. (PRESIDENT)
(631) 414-7181
Entity
Organization
Contact information
Practice address
1111 BROADHOLLOW RD, SUITE 204, FARMINGDALE, NY 11735-4820
(631) 414-7181
(631) 414-7178
Mailing address
32 SALLY LN, PLAINVIEW, NY 11803-1434
(516) 637-0689
(631) 414-7178
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
68-60276
NY
Other
Enumeration date
12/05/2006
Last updated
08/22/2020
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